Pregabalin for the treatment of postherpetic neuralgia

Dworkin, Robert H.; Corbin, A; Young, James P.; Sharma, Umang; LaMoreaux, L.; Bockbrader, Howard N.; Garofalo, Elizabeth; Poole, RM

doi:10.1212/01.wnl.0000055433.55136.55

Cited by 709 publications

(411 citation statements)

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“…This assessment time point has also been used in a number of pregabalin trials (Dworkin et al., 2003; Sabatowski et al., 2004). The established primary efficacy endpoint of ≥30% pain relief, as measured by the NPRS score, was employed.…”

Section: Methodsmentioning

confidence: 99%

Capsaicin 8% patch versus oral pregabalin in patients with peripheral neuropathic pain

Haanpää

Cruccu

Nurmikko

et al. 2015

European Journal of Pain

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BackgroundClinical trials have not yet compared the efficacy of capsaicin 8% patch with current standard therapy in peripheral neuropathic pain (PNP).ObjectivesHead‐to‐head efficacy and safety trial comparing the capsaicin patch with pregabalin in PNP.MethodsOpen‐label, randomized, multicentre, non‐inferiority trial. Patients with PNP, aged 18–80 years, were randomly assigned to either the capsaicin 8% patch (n = 282) or an optimised dose of oral pregabalin (n = 277), and assessed for a ≥30% mean decrease in Numeric Pain Rating Scale (NPRS) score from baseline to Week 8. Secondary endpoints included optimal therapeutic effect (OTE), time‐to‐onset of pain relief and treatment satisfaction.ResultsThe capsaicin 8% patch was non‐inferior to pregabalin in achievement of a ≥30% mean decrease in NPRS score from baseline to Week 8 (55.7% vs. 54.5%, respectively; Odds ratio: 1.03 [95% CI: 0.72, 1.50]). The proportion of patients achieving OTE at Week 8 was 52.1% for the capsaicin 8% patch versus 44.8% for pregabalin (difference: 7.3%; 95% CI: −0.9%, 15.6%). The median time‐to‐onset of pain relief was significantly shorter for capsaicin 8% patch versus pregabalin (7.5 vs. 36.0 days; Hazard ratio: 1.68 [95% CI: 1.35, 2.08]; p < 0.0001). Treatment satisfaction was also significantly greater with the capsaicin 8% patch versus pregabalin. TEAEs were mild‐to‐moderate in severity, and resulted in treatment discontinuation only with pregabalin (n = 24). Systemic adverse drug reactions ranged from 0 to 1.1% with capsaicin 8% patch and 2.5 to 18.4% with pregabalin.ConclusionsThe capsaicin 8% patch provided non‐inferior pain relief to an optimized dose of pregabalin in PNP, with a faster onset of action, fewer systemic side effects and greater treatment satisfaction.

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Section: Methodsmentioning

confidence: 99%

Capsaicin 8% patch versus oral pregabalin in patients with peripheral neuropathic pain

Haanpää

Cruccu

Nurmikko

et al. 2015

European Journal of Pain

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“…Dworkin et al 83 have demonstrated in a randomized placebo-controlled trial that, for patients with PHN, pregabalin-treated patients at doses of 300 or 600 mg each day had significantly reduced pain by the first day of treatment, and that by the end of this eight-week study the proportion of patients achieving at least 30%, or at least 50%, pain relief was significantly higher in those patients treated with pregabalin. In a separate randomized controlled PHN trial, Sabatowski et al 84 found that, at a dose of 300 mg/day compared with placebo, patients receiving pregabalin not only had significant pain reduction but also enjoyed improvement in sleep and mood.…”

Section: Pregabalinmentioning

confidence: 96%

Use of Antiepileptic Drugs for Nonepileptic Conditions: Psychiatric Disorders and Chronic Pain

2007

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Summary: Antiepileptic drugs (AEDs) are commonly utilized for nonepileptic conditions, including various psychiatric disorders and pain syndromes. Evidence for their benefit in these nonepileptic conditions varies widely among different drugs, but there is, in general, a paucity of published multicenter randomized double-blind trials. Variable levels of evidence suggest that lamotrigine and the vagal nerve stimulator have antidepressant properties. Carbamazepine, valproate, lamotrigine, and oxcarbazepine appear to have mood stabilizing properties while gabapentin, pregabalin, and tiagabine have anxiolytic benefits. Barbiturates, topiramate, and possibly phenytoin may precipitate or exacerbate depression. Underlying depression and anxiety symptoms may be exacerbated by levetiracetam, while psychotic symptoms have rarely been reported with topiramate, levetiracetam, and zonisamide. Pregabalin, gabapentin, carbamazepine, and oxcarbazepine have been used to treat neuropathic pain such as postherpetic neuralgia, and diabetic polyneuropathy. Topiramate and divalproex sodium have utility in the prophylaxis or acute treatment of migraine. Further rigorous studies are needed to clarify the utility of AEDs in nonepileptic conditions.

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“…In addition to intensity, pain is known to have different sensory and affective qualities that can be measured to de- 20,21 Recently, a revised version of the SF-MPQ, the SF-MPQ-2, has been published. 22 The major advantage of the SF-MPQ-2 is the addition of descriptors specific to neuropathic pain.…”

Section: Pain Qualitymentioning

confidence: 99%

Assessment and Treatment of Psychosocial Comorbidities in Patients With Neuropathic Pain

Turk

Audette

Levy

et al. 2010

Mayo Clinic Proceedings

144

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[3][4][5] In some studies, investigators reported that more than 40% of patients with implanted devices for pain control experience adverse events 6 ; up to 67.7% of patients treated with lumbar surgery for back pain reported that their pain was worse after surgery, 7 and at least moderate adverse effects have been reported to occur in 30% to 61% of all patients who undergo spinal manipulations. 8 These findings do not argue against the use of such treatments but serve as reminders of limitations and possible harmful effects. The mean duration of pain in patients who seek treatment at chronic pain treatment facilities is approximately 7 years. 9 Consequently, all domains of their lives may have been compromised for a substantial amount of time. It is hardly surprising that levels of emotional distress for patients with persistent pain are high. Estimates suggest that at least 1 current psychiatric diagnosis is present in 59% of patients with chronic back pain treated at pain facilities and at least 1 lifetime psychiatric diagnosis is present in 77% of these patients. 10 In contrast, community estimates are 15% for at least 1 current psychiatric diagnosis and 29% to 38% Chronic neuropathic pain is a prevalent problem that eludes cure and adequate treatment. The persistence of intense and aversive symptoms, inadequacy of available treatments, and impact of such pain on all aspects of functioning underscore the important role of several psychosocial factors in causing, maintaining, and amplifying the perception of pain severity, coping adequacy, adaptation, impaired physical function, and emotional distress responses. Moreover, these factors have an influential role in response to treatment recommendations. In this article, we (1) review the prevalence and nature of emotional distress, (2) describe and propose methods for screening and comprehensive psychosocial assessment, and (3) review evidence supporting the potential complementary role of psychosocial treatments of patients with chronic pain. The cognitive-behavioral perspective and treatment approach are emphasized because the greatest amount of evidence supports their benefits. Published results of psychological treatments are modest; however, the same indictment can be placed on currently available pharmacological, medical, and interventional treatments for patients with chronic pain. We note the limited research on the effectiveness of psychological treatment specifically applied to patients with chronic neuropathic pain but suggest that it is reasonable to extrapolate from successful trials in other types of chronic pain. Furthermore, psychological approaches should not be viewed as alternatives but rather should be integrated as part of a comprehensive approach to the treatment of patients with chronic neuropathic pain. Mayo Clin © 2010 Mayo Foundation for Medical Education and ResearchC hronic neuropathic pain is a prevalent problem that eludes successful treatment. Despite increasing knowledge of the neurophysiologic factors underlying neuropathic pa...

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Pregabalin for the treatment of postherpetic neuralgia

Abstract: Treatment of PHN with pregabalin is safe, efficacious in relieving pain and sleep interference, and associated with greater global improvement than treatment with placebo.

Cited by 709 publications

References 42 publications

Capsaicin 8% patch versus oral pregabalin in patients with peripheral neuropathic pain

Capsaicin 8% patch versus oral pregabalin in patients with peripheral neuropathic pain

Use of Antiepileptic Drugs for Nonepileptic Conditions: Psychiatric Disorders and Chronic Pain

Assessment and Treatment of Psychosocial Comorbidities in Patients With Neuropathic Pain

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