Short-Term Outcomes of Mirogabalin in Patients with Peripheral Neuropathic Pain: A Retrospective Study

Abstract

Background: Mirogabalin, which is approved for the treatment of peripheral neuropathic pain in Japan, is a ligand for the α2δ subunit of voltage-gated calcium channels. Both pregabalin and mirogabalin act as nonselective ligands at the α2δ-1 and α2δ-2 subunits. Mirogabalin has a unique binding profile and long duration of action. Pregabalin has been reported to produce intolerable adverse effects in some patients. This study investigated outcomes associated with mirogabalin administration in patients with peripheral neuropathic pain who ceased treatment with pregabalin.Methods: We retrospectively assessed peripheral neuropathic pain using the neuropathic pain screening questionnaire (NeP score) in 187 patients (58 men, 129 women) who were treated with mirogabalin. All patients had switched from pregabalin to mirogabalin due to lack of efficacy or adverse events. Differences in the treatment course (i.e., numeric rating scale (NRS) scores) were compared using one-way analysis of variance with Bonferroni post hoc tests.Results: The mean age of the patients was 72.3 years (range, 30–94 years), and the mean duration of disease was 37 months (range, 3–252 months). After treatment with mirogabalin for 1 week, NRS scores significantly decreased compared with baseline and continued to decrease over time. After 8 weeks, NRS scores improved by ³30% from baseline in 113 patients (69.3%). Twenty-four patients (12.8%) stopped mirogabalin treatment due to adverse events. Somnolence (26.7%), dizziness (12.3%), edema (5.9%), and weight gain (0.5%) were noted as adverse events of mirogabalin.Conclusions: The results of this investigation indicate that mirogabalin is safe and effective for reducing peripheral neuropathic pain.

Efficacy and safety of mirogabalin treatment in patients with diabetic peripheral neuropathic pain: A systematic review and meta‐analysis of randomised controlled trials

“…Recently, Tetsunaga et al reported their retrospective, single‐arm, single‐centre experience with mirogabalin in 187 DPNP patients 28 . All studied patients had switched from pregabalin to mirogabalin owing to reasons of absence of therapeutic responses or occurrence of side effects.…”

“…Additionally, they found the Recently, Tetsunaga et al reported their retrospective, singlearm, single-centre experience with mirogabalin in 187 DPNP patients. 28 All studied patients had switched from pregabalin to mirogabalin owing to reasons of absence of therapeutic responses or occurrence of side effects. Overall, pain NRS scores were substantially reduced after 1 week of mirogabalin and continued to reduce even further over the course of therapy.…”

Clinical Outcomes of Mirogabalin Treatment for Neuropathic Pain Due to Spinal Diseases in Patients Intolerant to Continuous Administration of Pregabalin

“…Tetsunaga et al reported good clinical outcomes of mirogabalin administration in patients with PNeP who discontinued pregabalin treatment due to AEs or lack of efficacy, although the participants of this study were not limited to those with spine diseases6) . Akazawa et al first reported the clinical outcomes of mirogabalin administration in patients with PNeP due to spinal diseases who discontinued pregabalin treatment.…”

“…According to previous studies, switching from pregabalin to mirogabalin in patients with PNeP resulted in good clinical outcomes [5][6] . Mirogabalin administration for PNeP due to lumbar spine disease is effective in improving leg symptoms, low back pain, and sleep disturbance 7) .…”

“…A Cochrane review of pregabalin reported that the withdrawal rate due to AEs was 3.6%-19% and that due to all causes was 12%-26% when pregabalin was administered at a dose of 600 mg daily 3) . There have been a few reports of PNeP treatment wherein pregabalin could not be administered continuously [4][5][6] , and it remains unclear which drug should be administered following this discontinuation.…”