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

  • Davari, Majid (Department of Pharmacoeconomics and Pharmaceutical Administration, Tehran University of Medical Sciences) ;
  • Amani, Bahman (Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences) ;
  • Amani, Behnam (Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences) ;
  • Khanijahani, Ahmad (Department of Health Administration and Public Health, John G. Rangos School of Health Sciences, Duquesne University) ;
  • Akbarzadeh, Arash (Department of Biostatistics and Epidemiology, School of Public Health, Tehran University of Medical Sciences) ;
  • Shabestan, Rouhollah (Department of Biostatistics and Epidemiology, School of Public Health, Tehran University of Medical Sciences)
  • Received : 2019.07.18
  • Accepted : 2019.12.10
  • Published : 2020.01.01

Abstract

Neuropathic pain after spinal cord injury (SCI) has a significant negative impact on the patients' quality of life. The objective of this systematic review is to examine the safety and efficacy of pregabalin (PGB) and gabapentin (GBP) in the treatment of neuropathic pain due to SCI. PubMed, the Cochrane Library, Embase, Scopus, and the Web of Science were searched up to December 2018. The reference lists of key and review studies were reviewed for additional citations. The quality of the studies was evaluated using the Cochrane Collaboration's tools for assessing the risk of bias. A meta-analysis was performed for primary and secondary outcomes. Eight studies were eligible for inclusion. Meta-analysis of PGB vs. placebo showed that PGB was effective for neuropathic pain (standardized mean difference [SMD] = -0.40; 95% confidence interval [CI]: -0.78, -0.01), anxiety (MD = -0.68; 95% CI: -0.77, -0.59), depression (mean difference [MD] = -0.99; 95% CI: -1.08, -0.89), and sleep interference (MD = -1.08; 95% CI: -1.13, -1.02). Also, GBP was more effective than a placebo for reducing pain. No significant difference was observed between the efficacy of the two drugs (MD = -0.37; 95% CI: -1.67, 0.93). There was no significant difference between the two drugs for discontinuation due to adverse events (risk ratio = 3.00; 95% CI: 0.81, 11.15). PGB and GBP were effective vs. placebos in decreasing neuropathic pain after SCI. Also, there was no significant difference between the two drugs for decreasing pain and adverse events.

Keywords

References

  1. Kamble SV, Motlekar SA, D'souza LL, Kudrigikar VN, Rao SE. Low doses of amitriptyline, pregabalin, and gabapentin are preferred for management of neuropathic pain in India: is there a need for revisiting dosing recommendations? Korean J Pain 2017; 30: 183-91. https://doi.org/10.3344/kjp.2017.30.3.183
  2. Werhagen L, Budh CN, Hultling C, Molander C. Neuropathic pain after traumatic spinal cord injury--relations to gender, spinal level, completeness, and age at the time of injury. Spinal Cord 2004; 42: 665-73. https://doi.org/10.1038/sj.sc.3101641
  3. Castro MM, Daltro C. Sleep patterns and symptoms of anxiety and depression in patients with chronic pain. Arq Neuropsiquiatr 2009; 67: 25-8. https://doi.org/10.1590/S0004-282X2009000100007
  4. Gore M, Brandenburg NA, Dukes E, Hoffman DL, Tai KS, Stacey B. Pain severity in diabetic peripheral neuropathy is associated with patient functioning, symptom levels of anxiety and depression, and sleep. J Pain Symptom Manage 2005; 30: 374-85. https://doi.org/10.1016/j.jpainsymman.2005.04.009
  5. Gormsen L, Rosenberg R, Bach FW, Jensen TS. Depression, anxiety, health-related quality of life and pain in patients with chronic fibromyalgia and neuropathic pain. Eur J Pain 2010; 14: 127.e1-8. https://doi.org/10.1016/j.ejpain.2009.03.010
  6. McDermott AM, Toelle TR, Rowbotham DJ, Schaefer CP, Dukes EM. The burden of neuropathic pain: results from a cross-sectional survey. Eur J Pain 2006; 10: 127-35. https://doi.org/10.1016/j.ejpain.2005.01.014
  7. Gustorff B, Dorner T, Likar R, Grisold W, Lawrence K, Schwarz F, et al. Prevalence of self-reported neuropathic pain and impact on quality of life: a prospective representative survey. Acta Anaesthesiol Scand 2008; 52: 132-6. https://doi.org/10.1111/j.1399-6576.2007.01486.x
  8. Hassanijirdehi M, Khak M, Afshari-Mirak S, Holakouie-Naieni K, Saadat S, Taheri T, et al. Evaluation of pain and its effect on quality of life and functioning in men with spinal cord injury. Korean J Pain 2015; 28: 129-36. https://doi.org/10.3344/kjp.2015.28.2.129
  9. Lude P, Kennedy P, Elfstrom ML, Ballert CS. Quality of life in and after spinal cord injury rehabilitation: a longitudinal multicenter study. Top Spinal Cord Inj Rehabil 2014; 20: 197-207. https://doi.org/10.1310/sci2003-197
  10. Dermanovic Dobrota V, Hrabac P, Skegro D, Smiljanic R, Dobrota S, Prkacin I, et al. The impact of neuropathic pain and other comorbidities on the quality of life in patients with diabetes. Health Qual Life Outcomes 2014; 12: 171. https://doi.org/10.1186/s12955-014-0171-7
  11. Geyh S, Ballert C, Sinnott A, Charlifue S, Catz A, D'Andrea Greve JM, et al. Quality of life after spinal cord injury: a comparison across six countries. Spinal Cord 2013; 51: 322-6. https://doi.org/10.1038/sc.2012.128
  12. Leem YJ, Joh JW, Joeng KW, Suh JH, Shin JW, Leem JG. Central pain from excitotoxic spinal cord injury induced by intraspinal NMDA injection: a pilot study. Korean J Pain 2010; 23: 109-15. https://doi.org/10.3344/kjp.2010.23.2.109
  13. Wollaars MM, Post MW, van Asbeck FW, Brand N. Spinal cord injury pain: the influence of psychologic factors and impact on quality of life. Clin J Pain 2007; 23: 383-91. https://doi.org/10.1097/AJP.0b013e31804463e5
  14. Smith BH, Torrance N, Bennett MI, Lee AJ. Health and quality of life associated with chronic pain of predominantly neuropathic origin in the community. Clin J Pain 2007; 23: 143-9. https://doi.org/10.1097/01.ajp.0000210956.31997.89
  15. Galvez R, Marsal C, Vidal J, Ruiz M, Rejas J. Cross-sectional evaluation of patient functioning and health-related quality of life in patients with neuropathic pain under standard care conditions. Eur J Pain 2007; 11: 244-55. https://doi.org/10.1016/j.ejpain.2006.02.002
  16. Davies M, Brophy S, Williams R, Taylor A. The prevalence, severity, and impact of painful diabetic peripheral neuropathy in type 2 diabetes. Diabetes Care 2006; 29: 1518-22. https://doi.org/10.2337/dc05-2228
  17. Teasell RW, Mehta S, Aubut JA, Foulon B, Wolfe DL, Hsieh JT, et al.; Spinal Cord Injury Rehabilitation Evidence Research Team. A systematic review of pharmacologic treatments of pain after spinal cord injury. Arch Phys Med Rehabil 2010; 91: 816-31. https://doi.org/10.1016/j.apmr.2010.01.022
  18. DeFrates S, Cook AM. Pharmacologic treatment of neuropathic pain following spinal cord injury. Orthopedics 2011; 34: 203. https://doi.org/10.3928/01477447-20110124-19
  19. Hagen EM, Rekand T. Management of neuropathic pain associated with spinal cord injury. Pain Ther 2015; 4: 51-65. https://doi.org/10.1007/s40122-015-0033-y
  20. Rowbotham M, Harden N, Stacey B, Bernstein P, Magnus-Miller L. Gabapentin for the treatment of postherpetic neuralgia: a randomized controlled trial. JAMA 1998; 280: 1837-42. https://doi.org/10.1001/jama.280.21.1837
  21. Rice AS, Maton S; Postherpetic Neuralgia Study Group. Gabapentin in postherpetic neuralgia: a randomised, double blind, placebo controlled study. Pain 2001; 94: 215-24. https://doi.org/10.1016/S0304-3959(01)00407-9
  22. Sabatowski R, Galvez R, Cherry DA, Jacquot F, Vincent E, Maisonobe P, et al.; 1008-045 Study Group. Pregabalin reduces pain and improves sleep and mood disturbances in patients with post-herpetic neuralgia: results of a randomised, placebo-controlled clinical trial. Pain 2004; 109: 26-35. https://doi.org/10.1016/j.pain.2004.01.001
  23. van Seventer R, Feister HA, Young JP Jr, Stoker M, Versavel M, Rigaudy L. Efficacy and tolerability of twice-daily pregabalin for treating pain and related sleep interference in postherpetic neuralgia: a 13-week, randomized trial. Curr Med Res Opin 2006; 22: 375-84. https://doi.org/10.1185/030079906X80404
  24. Moon DE, Lee DI, Lee SC, Song SO, Yoon DM, Yoon MH, et al. Efficacy and tolerability of pregabalin using a flexible, optimized dose schedule in Korean patients with peripheral neuropathic pain: a 10-week, randomized, double-blind, placebo-controlled, multicenter study. Clin Ther 2010; 32: 2370-85. https://doi.org/10.1016/j.clinthera.2011.01.014
  25. Xochilcal-Morales M, Castro EM, Guajardo-Rosas J, Obregon TN, Acevedo JC, Chucan JM, et al. A prospective, open-label, multicentre study of pregabalin in the treatment of neuropathic pain in Latin America. Int J Clin Pract 2010; 64: 1301-9. https://doi.org/10.1111/j.1742-1241.2010.02389.x
  26. Guan Y, Ding X, Cheng Y, Fan D, Tan L, Wang Y, et al. Efficacy of pregabalin for peripheral neuropathic pain: results of an 8-week, flexible-dose, double-blind, placebo-controlled study conducted in China. Clin Ther 2011; 33: 159-66. https://doi.org/10.1016/j.clinthera.2011.02.007
  27. Backonja M, Beydoun A, Edwards KR, Schwartz SL, Fonseca V, Hes M, et al. Gabapentin for the symptomatic treatment of painful neuropathy in patients with diabetes mellitus: a randomized controlled trial. JAMA 1998; 280: 1831-6. https://doi.org/10.1001/jama.280.21.1831
  28. Sandercock D, Cramer M, Wu J, Chiang YK, Biton V, Heritier M. Gabapentin extended release for the treatment of painful diabetic peripheral neuropathy: efficacy and tolerability in a double-blind, randomized, controlled clinical trial. Diabetes Care 2009; 32: e20. https://doi.org/10.2337/dc08-1450
  29. Tolle T, Freynhagen R, Versavel M, Trostmann U, Young JP Jr. Pregabalin for relief of neuropathic pain associated with diabetic neuropathy: a randomized, double-blind study. Eur J Pain 2008; 12: 203-13. https://doi.org/10.1016/j.ejpain.2007.05.003
  30. Guay DR. Pregabalin in neuropathic pain: a more "pharmaceutically elegant" gabapentin? Am J Geriatr Pharmacother 2005; 3: 274-87. https://doi.org/10.1016/j.amjopharm.2005.12.008
  31. Turner JA, Cardenas DD, Warms CA, McClellan CB. Chronic pain associated with spinal cord injuries: a community survey. Arch Phys Med Rehabil 2001; 82: 501-9. https://doi.org/10.1053/apmr.2001.21855
  32. Tzellos TG, Papazisis G, Amaniti E, Kouvelas D. Efficacy of pregabalin and gabapentin for neuropathic pain in spinalcord injury: an evidence-based evaluation of the literature. Eur J Clin Pharmacol 2008; 64: 851-8. https://doi.org/10.1007/s00228-008-0523-5
  33. Attal N, Mazaltarine G, Perrouin-Verbe B, Albert T; SOFMER French Society for Physical Medicine and Rehabilitation. Chronic neuropathic pain management in spinal cord injury patients. What is the efficacy of pharmacological treatments with a general mode of administration? (oral, transdermal, intravenous). Ann Phys Rehabil Med 2009; 52: 124-41. https://doi.org/10.1016/j.rehab.2008.12.011
  34. Snedecor SJ, Sudharshan L, Cappelleri JC, Sadosky A, Desai P, Jalundhwala YJ, et al. Systematic review and comparison of pharmacologic therapies for neuropathic pain associated with spinal cord injury. J Pain Res 2013; 6: 539-47. https://doi.org/10.2147/JPR.S45966
  35. Guy S, Mehta S, Leff L, Teasell R, Loh E. Anticonvulsant medication use for the management of pain following spinal cord injury: systematic review and effectiveness analysis. Spinal Cord 2014; 52: 89-96. https://doi.org/10.1038/sc.2013.146
  36. Mehta S, McIntyre A, Dijkers M, Loh E, Teasell RW. Gabapentinoids are effective in decreasing neuropathic pain and other secondary outcomes after spinal cord injury: a metaanalysis. Arch Phys Med Rehabil 2014; 95: 2180-6. https://doi.org/10.1016/j.apmr.2014.06.010
  37. Song F, Altman DG, Glenny AM, Deeks JJ. Validity of indirect comparison for estimating efficacy of competing interventions: empirical evidence from published meta-analyses. BMJ 2003; 326: 472. https://doi.org/10.1136/bmj.326.7387.472
  38. Moher D, Liberati A, Tetzlaff J, Altman DG; PRISMA Group. Preferred reporting items for systematic reviews and metaanalyses: the PRISMA statement. Ann Intern Med 2009; 151: 264-9. https://doi.org/10.7326/0003-4819-151-4-200908180-00135
  39. Tai Q, Kirshblum S, Chen B, Millis S, Johnston M, DeLisa JA. Gabapentin in the treatment of neuropathic pain after spinal cord injury: a prospective, randomized, double-blind, crossover trial. J Spinal Cord Med 2002; 25: 100-5. https://doi.org/10.1080/10790268.2002.11753609
  40. Levendoglu F, Ogun CO, Ozerbil O, Ogun TC, Ugurlu H. Gabapentin is a first line drug for the treatment of neuropathic pain in spinal cord injury. Spine (Phila Pa 1976) 2004; 29: 743-51. https://doi.org/10.1097/01.BRS.0000112068.16108.3A
  41. Siddall PJ, Cousins MJ, Otte A, Griesing T, Chambers R, Murphy TK. Pregabalin in central neuropathic pain associated with spinal cord injury: a placebo-controlled trial. Neurology 2006; 67: 1792-800. https://doi.org/10.1212/01.wnl.0000244422.45278.ff
  42. Rintala DH, Holmes SA, Courtade D, Fiess RN, Tastard LV, Loubser PG. Comparison of the effectiveness of amitriptyline and gabapentin on chronic neuropathic pain in persons with spinal cord injury. Arch Phys Med Rehabil 2007; 88: 1547-60. https://doi.org/10.1016/j.apmr.2007.07.038
  43. Vranken JH, Dijkgraaf MG, Kruis MR, van der Vegt MH, Hollmann MW, Heesen M. Pregabalin in patients with central neuropathic pain: a randomized, double-blind, placebocontrolled trial of a flexible-dose regimen. Pain 2008; 136: 150-7. https://doi.org/10.1016/j.pain.2007.06.033
  44. Cardenas DD, Nieshoff EC, Suda K, Goto S, Sanin L, Kaneko T, et al. A randomized trial of pregabalin in patients with neuropathic pain due to spinal cord injury. Neurology 2013; 80: 533-9. https://doi.org/10.1212/WNL.0b013e318281546b
  45. Kaydok E, Levendoglu F, Ozerbil MO, Karahan AY. Comparison of the efficacy of gabapentin and pregabalin for neuropathic pain in patients with spinal cord injury: a crossover study. Acta Med Mediterranea 2014; 30: 1343.
  46. Yilmaz B, Yasar E, Koroglu Omac O, Goktepe AS, Tan AK. Gabapentin vs. pregabalin for the treatment of neuropathic pain in patients with spinal cord injury: a crossover study. Turk J Phys Med Rehab 2014; 61: 1-5.
  47. Ghosh AK, Ghosh A, Kundu A, Das AK, Bhattacharya KB. Comparative study of efficacy and safety of pregabalin and gabapentin in neuropathic pain. Asian J Pharm Life Sci 2012; 2: 64-71.
  48. Donegan S, Williamson P, Gamble C, Tudur-Smith C. Indirect comparisons: a review of reporting and methodological quality. PLoS One 2010; 5: e11054. https://doi.org/10.1371/journal.pone.0011054
  49. Dworkin RH, O'Connor AB, Backonja M, Farrar JT, Finnerup NB, Jensen TS, et al. Pharmacologic management of neuropathic pain: evidence-based recommendations. Pain 2007; 132: 237-51. https://doi.org/10.1016/j.pain.2007.08.033
  50. Putzke JD, Richards JS, Kezar L, Hicken BL, Ness TJ. Longterm use of gabapentin for treatment of pain after traumatic spinal cord injury. Clin J Pain 2002; 18: 116-21. https://doi.org/10.1097/00002508-200203000-00007
  51. To TP, Lim TC, Hill ST, Frauman AG, Cooper N, Kirsa SW, et al. Gabapentin for neuropathic pain following spinal cord injury. Spinal Cord 2002; 40: 282-5. https://doi.org/10.1038/sj.sc.3101300
  52. Ahn SH, Park HW, Lee BS, Moon HW, Jang SH, Sakong J, et al. Gabapentin effect on neuropathic pain compared among patients with spinal cord injury and different durations of symptoms. Spine (Phila Pa 1976) 2003; 28: 341-6. https://doi.org/10.1097/01.BRS.0000048464.57011.00
  53. Song F, Loke YK, Walsh T, Glenny AM, Eastwood AJ, Altman DG. Methodological problems in the use of indirect comparisons for evaluating healthcare interventions: survey of published systematic reviews. BMJ 2009; 338: b1147. https://doi.org/10.1136/bmj.b1147
  54. Onouchi K, Koga H, Yokoyama K, Yoshiyama T. An openlabel, long-term study examining the safety and tolerability of pregabalin in Japanese patients with central neuropathic pain. J Pain Res 2014; 7: 439-47.

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