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Substitution of gabapentin therapy with pregabalin therapy in neuropathic pain due to peripheral neuropathy.

Abstract

OBJECTIVE

To determine the utility of substitution of pregabalin (PGB) for gabapentin (GBP) therapy in the relief of neuropathic pain (NeP) in patients with peripheral neuropathy (PN).

DESIGN

A cohort study was performed examining PGB substitution in patients who were GBP responders (> or =30% NeP relief on a visual analog scale [VAS]) or GBP nonresponders after prolonged GBP use, with further comparison to patients receiving continuous GBP therapy.

SETTING

Patients with PN and related NeP requiring GBP therapy were evaluated in a tertiary care neurological clinic at 0, 6, and 12 months.

OUTCOME MEASURES

Pain severity (Visual Analog Score [VAS]) was the primary outcome measure, while quality of life (European Quality of Life - 5 Domains [EQ-5D] and EQ-5D VAS) and occurrence of adverse events were secondary outcome measures.

RESULTS

Both GBP responder and nonresponder groups had additional NeP relief of about 25% following substitution of PGB after 6 and 12 months, while improved EQ-5D VAS was identified in the GBP nonresponder group. There were no serious adverse events for either medication, while GBP nonresponders discontinued PGB in more than 30% of cases due to inefficacy or adverse events.

CONCLUSIONS

Randomized, controlled, blinded head-to-head studies of GBP and PGB have not been published. The results of this open-label assessment of PGB substitution for GBP suggest that PGB may provide additional pain relief and possible improvement in quality of life above that received by GBP use in patients with NeP due to PN.

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  • Publisher Full Text
  • Authors+Show Affiliations

    Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada. corytoth@shaw.ca

    Source

    Pain medicine (Malden, Mass.) 11:3 2010 Mar pg 456-65

    MeSH

    Aged
    Amines
    Analgesics
    Cohort Studies
    Cyclohexanecarboxylic Acids
    Data Interpretation, Statistical
    Female
    Follow-Up Studies
    Gabapentin
    Humans
    Male
    Middle Aged
    Pain
    Pain Measurement
    Peripheral Nervous System Diseases
    Pregabalin
    Quality of Life
    Treatment Outcome
    gamma-Aminobutyric Acid

    Pub Type(s)

    Comparative Study
    Journal Article

    Language

    eng

    PubMed ID

    20113408

    Citation

    Toth, Cory. "Substitution of Gabapentin Therapy With Pregabalin Therapy in Neuropathic Pain Due to Peripheral Neuropathy." Pain Medicine (Malden, Mass.), vol. 11, no. 3, 2010, pp. 456-65.
    Toth C. Substitution of gabapentin therapy with pregabalin therapy in neuropathic pain due to peripheral neuropathy. Pain Med. 2010;11(3):456-65.
    Toth, C. (2010). Substitution of gabapentin therapy with pregabalin therapy in neuropathic pain due to peripheral neuropathy. Pain Medicine (Malden, Mass.), 11(3), pp. 456-65. doi:10.1111/j.1526-4637.2009.00796.x.
    Toth C. Substitution of Gabapentin Therapy With Pregabalin Therapy in Neuropathic Pain Due to Peripheral Neuropathy. Pain Med. 2010;11(3):456-65. PubMed PMID: 20113408.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Substitution of gabapentin therapy with pregabalin therapy in neuropathic pain due to peripheral neuropathy. A1 - Toth,Cory, Y1 - 2010/01/22/ PY - 2010/2/2/entrez PY - 2010/2/2/pubmed PY - 2010/8/4/medline SP - 456 EP - 65 JF - Pain medicine (Malden, Mass.) JO - Pain Med VL - 11 IS - 3 N2 - OBJECTIVE: To determine the utility of substitution of pregabalin (PGB) for gabapentin (GBP) therapy in the relief of neuropathic pain (NeP) in patients with peripheral neuropathy (PN). DESIGN: A cohort study was performed examining PGB substitution in patients who were GBP responders (> or =30% NeP relief on a visual analog scale [VAS]) or GBP nonresponders after prolonged GBP use, with further comparison to patients receiving continuous GBP therapy. SETTING: Patients with PN and related NeP requiring GBP therapy were evaluated in a tertiary care neurological clinic at 0, 6, and 12 months. OUTCOME MEASURES: Pain severity (Visual Analog Score [VAS]) was the primary outcome measure, while quality of life (European Quality of Life - 5 Domains [EQ-5D] and EQ-5D VAS) and occurrence of adverse events were secondary outcome measures. RESULTS: Both GBP responder and nonresponder groups had additional NeP relief of about 25% following substitution of PGB after 6 and 12 months, while improved EQ-5D VAS was identified in the GBP nonresponder group. There were no serious adverse events for either medication, while GBP nonresponders discontinued PGB in more than 30% of cases due to inefficacy or adverse events. CONCLUSIONS: Randomized, controlled, blinded head-to-head studies of GBP and PGB have not been published. The results of this open-label assessment of PGB substitution for GBP suggest that PGB may provide additional pain relief and possible improvement in quality of life above that received by GBP use in patients with NeP due to PN. SN - 1526-4637 UR - https://www.unboundmedicine.com/medline/citation/20113408/Substitution_of_gabapentin_therapy_with_pregabalin_therapy_in_neuropathic_pain_due_to_peripheral_neuropathy_ L2 - https://academic.oup.com/painmedicine/article-lookup/doi/10.1111/j.1526-4637.2009.00796.x DB - PRIME DP - Unbound Medicine ER -