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This trial showed that the three commonly used treatment pathways in adults with diabetic peripheral neuropathic pain give comparable patient outcomes in a UK secondary care setting.

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Solomon Tesfaye 1,2,*, Gordon Sloan 1, Jennifer Petrie 3, David White 3, Mike Bradburn 3, Tracey Young 4, Satyan Rajbhandari 5, Sanjeev Sharma 6, Gerry Rayman 6, Ravikanth Gouni 7, Uazman Alam 8,9, Steven A Julious 10, Cindy Cooper 3, Amanda Loban 3, Katie Sutherland 3, Rachel Glover 3, Simon Waterhouse 3, Emily Turton 3, Michelle Horspool 11, Rajiv Gandhi 1, Deirdre Maguire 12, Edward Jude 13,14, Syed Haris Ahmed 8,15, Prashanth Vas 16, Christian Hariman 17, Claire McDougall 18, Marion Devers 19, Vasileios Tsatlidis 20, Martin Johnson 21, Didier Bouhassira 22, David L Bennett 23, Dinesh Selvarajah 2

1 Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
2 Department of Oncology and Human Metabolism, Medical School, University of Sheffield, Sheffield, UK
3 Clinical Trials Research Unit, University of Sheffield, School of Health and Related Research (ScHARR), Sheffield, UK
4 School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK
5 Lancashire Teaching Hospitals NHS Trust, Chorley, UK
6 East Suffolk and North Essex NHS Foundation Trust, Ipswich, UK
7 Nottingham University Hospitals NHS Trust, Nottingham, UK
8 University of Liverpool, Liverpool, UK
9 Liverpool University Hospital NHS Foundation Trust, Liverpool, UK
10 Medical Statistics Group, School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK
11 NHS Sheffield Clinical Commissioning Group, Sheffield, UK
12 Harrogate and District NHS Foundation Trust, Harrogate, UK
13 Tameside and Glossop Integrated Care NHS Foundation Trust, Ashton under Lyne, UK
14 University of Manchester, Manchester, UK
15 Countess of Chester Hospital NHS Foundation Trust, Chester, UK
16 King’s College Hospital NHS Foundation Trust, London, UK
17 Royal Wolverhampton NHS Trust, Wolverhampton, UK
18 University Hospital Hairmyres, East Kilbride, UK
19 University Hospital Monklands, Airdrie, UK
20 Gateshead Health NHS Foundation Trust, Gateshead, UK
21 hVIVO Services Limited, London, UK
22 Hospital Ambroise Paré, Paris, France
23 Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
* Corresponding author Email: solomon.tesfaye@nhs.net

Declared competing interests of authors: Solomon Tesfaye reports honoraria as speaker fees from Wörwag Pharma (Stuttgart, Germany), Pfizer Inc. (Pfizer Inc., New York, NY, USA), Novo Nordisk (Bagsværd, Denmark), Merck & Co. Inc. (Kenilworth, NJ, USA), Eva Pharma (Cairo, Egypt), Hikma Pharmaceuticals plc (London, UK), Abbott Laboratories (Abbott Park, IL, USA), AstraZeneca (Cambridge, UK), Nevro (Redwood City, CA, USA), Procter & Gamble Health Limited (Mumbai, India), Astellas Pharma Inc. (Tokyo, Japan) and Berlin-Chemi (Berlin, Germany), and is on the advisory boards (from 2018 to present) of Bayer AG (Leverkusen, Germany), NeuroPn Therapeutics (Norcross, GA, USA), Wörwag Pharma, Angelini (Rome, Italy), Grünenthal (Aachen, Germany), TRIGOcare International GmbH (Wiehl, Germany), Nevro, Mitsubishi Tanabe Pharma Corporation (Osaka, Japan) and Confo Therapeutics (Gent, Belgium). Uazman Alam reports honoraria for educational meetings from Eli Lilly and Company (Indianapolis, IN, USA), Napp Pharmaceuticals Ltd (Cambridge, UK), Sanofi (Paris, France) and Boehringer Ingelheim (Ingelheim am Rhein, Germany). Edward Jude reports honoraria and research support from AstraZeneca, Bayer AG, Menarini (Florence, Italy), Napp Pharmaceuticals Ltd, Novo Nordisk and Sanofi. Syed Haris Ahmed reports honoraria for educational meetings from Novo Nordisk (Bagsværd, Denmark), Eli Lilly and Company (Indianapolis, IN, USA) and Sanofi (Paris, France). Prashanth Vas reports honoraria from Merck & Co. Inc. and Sanofi. Martin Johnson reports honoraria for advisory boards and speaker fees from Grünenthal (2015 to present), and is a co-chairperson, since 2014, of the Chronic Pain Policy Coalition (London, UK) and a council (2012 to present) and ordinary member of the British Pain Society (London, UK). Didier Bouhassira reports honoraria for consulting activities for Bayer AG, Grünenthal, Novartis Pharmaceuticals UK Ltd (London, UK) and Air Liquide (Paris, France). David L Bennett has acted as a consultant on behalf of Oxford University Innovation Limited (Oxford, UK) for AditumBio (San Francisco, CA, USA), Amgen Inc. (Thousand Oaks, CA, USA), Bristows LLP (London, UK), Latigo Biotherapeutics Inc. (Thousand Oaks, CA, USA), GlaxoSmithKline plc, Ionis Pharmaceuticals (Carlsbad, CA, USA), Eli Lilly and Company, OliPass (Gyeonggi, Republic of Korea), Regeneron Pharmaceuticals (Tarrytown, NY, USA) and Theranexus (Lyon, France) (2020–21). David L Bennett has received research funding from Eli Lilly and Company and AstraZeneca, and has received an industrial partnership grant from the Biotechnology and Biological Sciences Research Council (BBSRC) (Swindon, UK) and AstraZeneca. David L Bennett reports grants and contracts for a number of studies from the following: the UK Research and Innovation (Swindon, UK) (Versus MR/W002388/1), Medical Research Council (MRC) (MR/T020113/1), BBSRC (BB/S006788/1), Action Medical Research for Children (West Sussex, UK), MRC Research Grant, Wellcome Trust Senior Clinical Scientist Fellowship, Novo Nordisk Foundation (Hellerup, Denmark), European Union Horizon 2020, MRC Clinical Research Training Fellowship and Wellcome Trust Strategic Award. Dinesh Selvarajah reports membership of the advisory boards of Impeto Medical (Issy-les-Moulineaux, France) (2017), PelliTec Inc. (Chester, UK) (2020) and FeetMe Inc. (Paris, France) (2019). Cindy Cooper reports membership of the following committees: the National Institute for Health and Care Research (NIHR) Clinical Trial Unit (CTU) Support Funding Committee (2016 to present), NIHR CTU Standing Advisory Committee (2016–22), NIHR Programme Grant for Applied Research Subcommittee (2017–21) and Trial Steering Committees for other NIHR-funded trials.

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