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Gabapentin in postherpetic neuralgia: a randomised, double blind, placebo controlled study.

Abstract

A multicentre double blind, randomised, placebo controlled 7-week study evaluated the efficacy and safety of gabapentin 1800 or 2400 mg/day in treating postherpetic neuralgia. Three hundred and thirty-four men and women aged at least 18 years (mean 73) received gabapentin 1800 or 2400 mg daily or placebo in three divided doses with a forced titration schedule. The primary outcome measure was change in average daily pain diary score (baseline week v final week). Secondary outcomes included mean weekly sleep interference score; Short Form-McGill Pain Questionnaire (SF-MPQ); Clinician and Patient Global Impression of Change (CGIC/PGIC); Short Form-36 Health Survey (SF-36). From week 1, pain scores showed a significantly greater improvement with gabapentin: the final difference v baseline was -34.5% for the 1800 mg dose, -34.4% for the 2400 mg dose compared with -15.7% for the placebo group. The difference vs. placebo was 18.8% for the 1800 mg dose (95% confidence interval 10.9-26.8%; P<0.01) and 18.7% for the 2400 mg dose (10.7-26.7%; P<0.01). Sleep interference diaries showed a similar pattern. There were significant differences in favour of gabapentin for number of patients reporting >50% reduction in their pain intensity, in the CGIC and PGIC, in the sensory and total scores of the SF-MPQ (both doses), in the visual analogue scale of pain of the SF-MPQ (2400 mg only) and in the vitality, bodily pain and mental health domains of the SF-36. Overall gabapentin was well tolerated. The most common adverse events were dizziness and somnolence, particularly during the titration phase. Thus, this study confirms the role of gabapentin as an efficacious and well-tolerated treatment for postherpetic neuralgia.

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  • Authors+Show Affiliations

    ,

    Pain Research Group, Department of Anaesthetics, Imperial College School of Medicine, Chelsea and Westminster Hospital Campus, 369 Fulham Road, London SW10 9NH, UK. a.rice@ic.ac.uk

    ,

    Source

    Pain 94:2 2001 Nov pg 215-24

    MeSH

    Acetates
    Adult
    Aged
    Aged, 80 and over
    Amines
    Analgesics
    Cyclohexanecarboxylic Acids
    Double-Blind Method
    Female
    Gabapentin
    Herpes Zoster
    Humans
    Male
    Middle Aged
    Neuralgia
    Pain Measurement
    Patient Satisfaction
    Quality of Life
    Treatment Outcome
    gamma-Aminobutyric Acid

    Pub Type(s)

    Clinical Trial
    Journal Article
    Multicenter Study
    Randomized Controlled Trial
    Research Support, Non-U.S. Gov't

    Language

    eng

    PubMed ID

    11690735

    Citation

    Rice, A S., et al. "Gabapentin in Postherpetic Neuralgia: a Randomised, Double Blind, Placebo Controlled Study." Pain, vol. 94, no. 2, 2001, pp. 215-24.
    Rice AS, Maton S, Postherpetic Neuralgia Study Group. Gabapentin in postherpetic neuralgia: a randomised, double blind, placebo controlled study. Pain. 2001;94(2):215-24.
    Rice, A. S., & Maton, S. (2001). Gabapentin in postherpetic neuralgia: a randomised, double blind, placebo controlled study. Pain, 94(2), pp. 215-24.
    Rice AS, Maton S, Postherpetic Neuralgia Study Group. Gabapentin in Postherpetic Neuralgia: a Randomised, Double Blind, Placebo Controlled Study. Pain. 2001;94(2):215-24. PubMed PMID: 11690735.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Gabapentin in postherpetic neuralgia: a randomised, double blind, placebo controlled study. AU - Rice,A S, AU - Maton,S, AU - ,, PY - 2001/11/3/pubmed PY - 2002/1/12/medline PY - 2001/11/3/entrez SP - 215 EP - 24 JF - Pain JO - Pain VL - 94 IS - 2 N2 - A multicentre double blind, randomised, placebo controlled 7-week study evaluated the efficacy and safety of gabapentin 1800 or 2400 mg/day in treating postherpetic neuralgia. Three hundred and thirty-four men and women aged at least 18 years (mean 73) received gabapentin 1800 or 2400 mg daily or placebo in three divided doses with a forced titration schedule. The primary outcome measure was change in average daily pain diary score (baseline week v final week). Secondary outcomes included mean weekly sleep interference score; Short Form-McGill Pain Questionnaire (SF-MPQ); Clinician and Patient Global Impression of Change (CGIC/PGIC); Short Form-36 Health Survey (SF-36). From week 1, pain scores showed a significantly greater improvement with gabapentin: the final difference v baseline was -34.5% for the 1800 mg dose, -34.4% for the 2400 mg dose compared with -15.7% for the placebo group. The difference vs. placebo was 18.8% for the 1800 mg dose (95% confidence interval 10.9-26.8%; P<0.01) and 18.7% for the 2400 mg dose (10.7-26.7%; P<0.01). Sleep interference diaries showed a similar pattern. There were significant differences in favour of gabapentin for number of patients reporting >50% reduction in their pain intensity, in the CGIC and PGIC, in the sensory and total scores of the SF-MPQ (both doses), in the visual analogue scale of pain of the SF-MPQ (2400 mg only) and in the vitality, bodily pain and mental health domains of the SF-36. Overall gabapentin was well tolerated. The most common adverse events were dizziness and somnolence, particularly during the titration phase. Thus, this study confirms the role of gabapentin as an efficacious and well-tolerated treatment for postherpetic neuralgia. SN - 0304-3959 UR - https://www.unboundmedicine.com/medline/citation/11690735/Gabapentin_in_postherpetic_neuralgia:_a_randomised_double_blind_placebo_controlled_study_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0304-3959(01)00407-9 DB - PRIME DP - Unbound Medicine ER -