Prof. Keppel Hesselink and Dr Kopsky publlished an interesting paper on the efficacy and safety of palmitoylethanolamide (PEA) in nerve compression syndromes. They reviewed all preclinical and clinical literature in this field and conducted a NNT analysis on a ITT population of 636 patients suffering from sciatic pain. The NNT was impressive: 1.5 . All preclinical paradigms for nerve compression supported the analgesic efficacy of palmitoylethanolamide. Furthermore, they discussed the results from eight clinical trials of PEA used in nerve entrapment syndromes, with a total of 1,366 patients included in these trials.
PEA proved to be effective and safe in nerve compression syndromes. In one pivotal, double blind, placebo controlled trial in 636 sciatic pain patients, the number needed to treat to reach 50% pain reduction compared to baseline was 1.5 after 3 weeks of treatment. Furthermore, no drug interactions or troublesome side effects have been described so far. Physicians are not always aware of PEA as a relevant and safe alternative to opioids and co-analgesics in the treatment of neuropathic pain. Especially since the often prescribed co-analgesic pregabaline has been proven to be ineffective in sciatic pain in a double blind enrichment trial, PEA should be considered as a new and safe treatment option for nerve compression syndromes.
Source: Keppel Hesselink JM, Kopsky DJ. Palmitoylethanolamide, a neutraceutical, in nerve compression syndromes: efficacy and safety in sciatic pain and carpal tunnel syndrome. Journal of Pain Research Volume 2015:8 Pages 729—734.