Oxcarbazepine is effective and safe in the treatment of neuropathic pain: pooled analysis of seven clinical studies

Abstract

The results of 7 open-label clinical studies on oxcarbazepine (OXC) in different neuropathic pain conditions, sharing the same protocols, were pooled together in order to evaluate whether the results obtained in the individual trials were confirmed in the pooled analysis of this larger sample, providing more evidence for efficacy and tolerability of OXC in these conditions. Eligible patients (>18 years old) with a diagnosis of neuropathic pain were enrolled in seven open-label trials, consisting of a one-week prospective Screening Phase followed by an eight-week Treatment Phase. Treatment with OXC was initiated at 150 mg/day, and the daily dose was increased by 150 mg/day on a 2-3 day basis to the maximum tolerated dose over four weeks, up to 1800 mg/day. The primary outcome measure was the change in the actual pain rating assessed on the visual analogue scale (VAS) between the end of the Screening Phase and the end of the Treatment Phase. One hundred and thirty-six patients were enrolled in the trials. The mean VAS score dropped from 77.13 at the end of the Screening Phase to 38.41 at the end of the trial for a mean reduction of 50.2%. The percentage of responders (mean VAS score reduction > or = 50%) was 49.2%. OXC was well tolerated, with the most common adverse events consisting of vertigo, tremor, somnolence, hypotension and nausea. The results of this analysis suggest that OXC administered as monotherapy is an efficacious and safe option for the symptomatic treatment of pain associated with neuropathies.

Characteristics of selected second-generation antiepileptic drugs used in dogs

“…In humans the efficacy was confirmed in a large randomised, double-blind study (Guerreiro et al 1997). Also, some data indicate that OXC may be useful in the management of neuropathic pain (Magenta et al 2005). The mechanism of action of this agent is similar to that of carbamazepine.…”

Vertigo/dizziness as a Drugs' adverse reaction

“…As already reported, oxcarbazepine, useful in the symptomatic treatment of pain associated with neuropathies, is well tolerated with the most common adverse events consisting of vertigo, tremor, somnolence, hypotension, and nausea. [47,48] Most of the side-effects associated with carbamazepine therapy are mild, transient, and reversible with an adjustment in dosage or rate of dosage increase. In a study of the incidence of side-effects in 220 children below the age of 16 years who were receiving carbamazepine, drowsiness, loss of coordination, and vertigo were the most commonly observed side-effects.…”

Voltage-gated sodium channel blockers for the treatment of neuropathic pain

“…Oxcarbazepine, a newer analog of carbamazepine with reduced liver metabolism that is also likely to interact with sodium channels [143], has been shown to have potential for treating allodynia and hyperalgesia in animal models of neuropathic pain [144]. Clinical studies suggest that oxcarbazepine may be effective at treating several types of neuropathic pain [145], including pain associated with multiple sclerosis [146] and painful diabetic neuropathy [147][148][149]. Lamotrigine is another anticonvulsant whose activity is due, at least in part, to inhibition of voltage-gated sodium channels [140,150].…”