Pregabalin and gabapentin in neuropathic pain management after spinal cord injury: a systematic review and meta-analysis

Davari, Majid; Amani, Bahman; Amani, Behnam; Khanijahani, Ahmad; Akbarzadeh, Arash; Shabestan, Rouhollah

doi:10.3344/kjp.2020.33.1.3

Cited by 56 publications

(45 citation statements)

References 53 publications

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“…A number of studies have reported different adverse events associated with gabapentinoids, notably dizziness and somnolence 5 . Moreover, some studies have reported a higher incidence of AEs and discontinuation of treatment with pregabalin possibly due to higher prescription frequency for different neuropathic conditions 29,30 . In our study, we found a significant association of polymorphism in rs4240803 with different adverse effects of gabapentinoids and maximum AEs were observed in patients with GA genotype.…”

Section: Discussionsupporting

confidence: 60%

“…5 Moreover, some studies have reported a higher incidence of AEs and discontinuation of treatment with pregabalin possibly due to higher prescription frequency for different neuropathic conditions. 29,30 In our study, we found a significant association of polymorphism in rs4240803 with different adverse effects of gabapentinoids and maximum AEs were observed in patients with GA genotype. Out of 69 patients discontinuing gabapentinoids, 44 patients stopped due to severe dizziness and somnolence.…”

Section: Discussionsupporting

confidence: 52%

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Influence of single nucleotide polymorphism of LAT1 on therapeutic response to gabapentinoids in Pakistani patients with neuropathic pain

Shaheen

Alam

Azam

et al. 2020

Basic Clin Pharma Tox

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Gabapentinoids are substrate of L‐type amino acid transporter 1 (LAT1) for distribution across the blood‐brain barrier. The present study aimed to evaluate the effect of LAT1 rs4240803 genetic polymorphism on the clinical efficacy and tolerability of gabapentinoids in Pakistani patients with neuropathic pain. Three‐hundred and ninety‐two patients were recruited, genotyped for SNP rs4240803, and followed up for eight weeks to evaluate the clinical response to gabapentinoids in terms of pain relief, inadequate response, and the emergence of adverse events. LAT1 rs4240803 GG, GA, and AA genotype frequency were 33.42%, 47.96% and 18.62%, respectively. Out of 392 patients, 323 responded to the treatment and 17.6% discontinued either due to insufficient response or intolerable adverse events (AEs). GA genotype was more frequent in non‐responder group (P ˂ 0.001). Maximum pain responders (≥50%) in combination with the lowest incidence of AEs were observed in the GG group, whereas partial responders belonged to GA genotype and with the highest frequency of somnolence (83.6%) and dizziness (69.9%). Overall, 72.5% patients with GA genotype experienced AEs (P ˂ 0.001). In conclusion, clinical outcomes of gabapentinoids are influenced by LAT1 rs4240803 polymorphism and population pharmacogenetics should be considered to evaluate the maximum potential of gabapentinoids in the management of neuropathic pain.

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Section: Discussionsupporting

confidence: 60%

Section: Discussionsupporting

confidence: 52%

Influence of single nucleotide polymorphism of LAT1 on therapeutic response to gabapentinoids in Pakistani patients with neuropathic pain

Shaheen

Alam

Azam

et al. 2020

Basic Clin Pharma Tox

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“…A previous meta-analysis indicated that pregabalin could decrease postoperative pain after spinal cord injury, 11 diabetic neuralgia, 12 and neuropathic pain; 10 however, the role of pregabalin following hysterectomy has yet to be defined. Asgari et al.…”

Section: Introductionmentioning

confidence: 99%

Pregabalin does not decrease acute pain or postoperative nausea and vomiting after hysterectomy: a meta-analysis

Ni¹,

Juan²,

Shiqin³

et al. 2020

J Int Med Res

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Objective Hysterectomy is associated with severe postoperative pain. The relative efficacy of pregabalin compared with other treatments for post-hysterectomy pain is unclear. Methods We searched the PubMed, Cochrane Library, and Web of Science databases for studies that compared the use of pregabalin and placebo for reducing pain in patients undergoing hysterectomy. Results This meta-analysis showed that pregabalin had limited pain-relieving effects at 2, 6, 24, and 48 hours after hysterectomy compared with placebo. Pregabalin significantly reduced postoperative nausea and vomiting. However, there was no significant difference in postoperative sedation or visual disturbances between patients treated with pregabalin and placebo. Conclusions Pregabalin is not clinically superior to placebo in terms of reducing pain intensity and morphine consumption in patients undergoing hysterectomy. However, the limitations of this meta-analysis mean that more high-quality randomized controlled trials are necessary to verify our pooled results.

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“…Thus both gabapentin and Pregabalin had efficacy vs placebo in reducing NP secondary to SCI. Further no significant variation in the 2 drugs for reducing pain as well as side effects was observed [18].…”

Section: Mechanism Of Action Of Gabapentinoidsmentioning

confidence: 90%

Aetiology of Neuropathic Pain (NP) Along with Role of Gabapentinoids Like Pregabalin and Gabapentin in Treating the Excruciating Pain Besides Other Newer Alternatives-a Systematic Review

2020

JAPM

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Neuropathic pain (NP) by definition is a problem that involves the somatosensory system either as a manifestation as disease or as a lesion. Lot of differing causes either of central/peripheral origin can stimulate NP and that might affect life’s quality badly. Worldwide prevalence of NP varies from 6.9-10% with spinal cord injury (SCI) explaining 40% of them. The 2nd commonest cause is diabetic peripheral neuropathy (DPN) that accounts for 22-28% of type 2 diabetes mellitus (T2DM). After having reviewed thoroughly how to manage diabetic neuropathic pain here we decided to conduct a systematic review on varying causes of NP and the role of gabapentenoids in managing the excruciating pain. Besides newer opioid analogues not having addictive potential like fentanyl matrix with its availability in intradermal formulations, delta opioid receptor agonist BBI-11008, an innovative analog N-(1-benzylpiperidin-4-yl)-4-fluorobenzamide (LMH2), that is like haloperidol, along with advantages of Gabapentin-ER as well as therapy of trigeminal neuralgia with anticonvulsants like carbamazepine and use in Immunotherapy utilizing 14,18 anti GD2 antibody (ch14.18) associated excruciating pain and in Meralgia paraesthetica (MP) is discussed besides alternative therapies when gabapentenoids fail.

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Pregabalin and gabapentin in neuropathic pain management after spinal cord injury: a systematic review and meta-analysis

Cited by 56 publications

References 53 publications

Influence of single nucleotide polymorphism of LAT1 on therapeutic response to gabapentinoids in Pakistani patients with neuropathic pain

Influence of single nucleotide polymorphism of LAT1 on therapeutic response to gabapentinoids in Pakistani patients with neuropathic pain

Pregabalin does not decrease acute pain or postoperative nausea and vomiting after hysterectomy: a meta-analysis

Aetiology of Neuropathic Pain (NP) Along with Role of Gabapentinoids Like Pregabalin and Gabapentin in Treating the Excruciating Pain Besides Other Newer Alternatives-a Systematic Review

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