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Efficacy and safety of gabapentin for treatment of postherpetic neuralgia: a meta-analysis of randomized controlled trials.
Minerva Anestesiol. 2014 May; 80(5):556-67.MA

Abstract

BACKGROUND

Postherpetic neuralgia (PHN) is a common type of neuropathic pain occurring after resolution of herpes zoster rash. Although gabapentin is a widely used treatment, some disagreements exist about its efficacy and safety. Meta-analysis was performed to better evaluate the efficacy and safety of gabapentin for management of PHN.

METHODS

Randomized, double-blind, placebo-controlled trials of gabapentin to treat PHN were identified by searching MEDLINE, EMBASE, and CENTRAL databases. Searches were restricted to studies published in English.

RESULTS

Seven trials involving a total of 2039 participants were identified. Pooled analysis showed that gabapentin reduced PHN-related pain significantly more than placebo (mean difference, MD=-0.89, 95% CI -1.58 to -0.18, P<0.001). Gabapentin reduced pain below baseline by at least 50% in significantly more patients than did placebo (RR=1.59, 95% CI 1.35 to 1.88, P<0.001). Gabapentin was significantly more likely than placebo to lead patients to rate their global impression of change as "much improved" or "very much improved" (RR=1.82, 95% CI 1.41 to 2.35, P=0.003). Gabapentin also improved sleep quality significantly more than did placebo (MD=-0.62, 95% CI -0.67 to -0.57, P<0.001). On the other hand, patients given gabapentin were significantly more likely to experience dizziness, somnolence, peripheral edema, ataxia or gait disturbance and diarrhea. Subgroup analysis on formulation of gabapentin showed that gabapentin enacarbil had similar efficacy of pain relief with other formulations while it may be superior to others in term of compliance and safety.

CONCLUSION

This meta-analysis indicates that gabapentin is an effective and well-tolerated treatment for patients with PHN.

Authors+Show Affiliations

Department of Anesthesiology, Tumor Hospital of Guangxi Medical University, Nanning, People's Republic of China - ykdxliangrui@163.com.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Meta-Analysis
Review

Language

eng

PubMed ID

24257149

Citation

Meng, F Y., et al. "Efficacy and Safety of Gabapentin for Treatment of Postherpetic Neuralgia: a Meta-analysis of Randomized Controlled Trials." Minerva Anestesiologica, vol. 80, no. 5, 2014, pp. 556-67.
Meng FY, Zhang LC, Liu Y, et al. Efficacy and safety of gabapentin for treatment of postherpetic neuralgia: a meta-analysis of randomized controlled trials. Minerva Anestesiol. 2014;80(5):556-67.
Meng, F. Y., Zhang, L. C., Liu, Y., Pan, L. H., Zhu, M., Li, C. L., Li, Y. W., Qian, W., & Liang, R. (2014). Efficacy and safety of gabapentin for treatment of postherpetic neuralgia: a meta-analysis of randomized controlled trials. Minerva Anestesiologica, 80(5), 556-67.
Meng FY, et al. Efficacy and Safety of Gabapentin for Treatment of Postherpetic Neuralgia: a Meta-analysis of Randomized Controlled Trials. Minerva Anestesiol. 2014;80(5):556-67. PubMed PMID: 24257149.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Efficacy and safety of gabapentin for treatment of postherpetic neuralgia: a meta-analysis of randomized controlled trials. AU - Meng,F Y, AU - Zhang,L C, AU - Liu,Y, AU - Pan,L H, AU - Zhu,M, AU - Li,C L, AU - Li,Y W, AU - Qian,W, AU - Liang,R, Y1 - 2013/11/21/ PY - 2013/11/22/entrez PY - 2013/11/22/pubmed PY - 2015/7/7/medline SP - 556 EP - 67 JF - Minerva anestesiologica JO - Minerva Anestesiol VL - 80 IS - 5 N2 - BACKGROUND: Postherpetic neuralgia (PHN) is a common type of neuropathic pain occurring after resolution of herpes zoster rash. Although gabapentin is a widely used treatment, some disagreements exist about its efficacy and safety. Meta-analysis was performed to better evaluate the efficacy and safety of gabapentin for management of PHN. METHODS: Randomized, double-blind, placebo-controlled trials of gabapentin to treat PHN were identified by searching MEDLINE, EMBASE, and CENTRAL databases. Searches were restricted to studies published in English. RESULTS: Seven trials involving a total of 2039 participants were identified. Pooled analysis showed that gabapentin reduced PHN-related pain significantly more than placebo (mean difference, MD=-0.89, 95% CI -1.58 to -0.18, P<0.001). Gabapentin reduced pain below baseline by at least 50% in significantly more patients than did placebo (RR=1.59, 95% CI 1.35 to 1.88, P<0.001). Gabapentin was significantly more likely than placebo to lead patients to rate their global impression of change as "much improved" or "very much improved" (RR=1.82, 95% CI 1.41 to 2.35, P=0.003). Gabapentin also improved sleep quality significantly more than did placebo (MD=-0.62, 95% CI -0.67 to -0.57, P<0.001). On the other hand, patients given gabapentin were significantly more likely to experience dizziness, somnolence, peripheral edema, ataxia or gait disturbance and diarrhea. Subgroup analysis on formulation of gabapentin showed that gabapentin enacarbil had similar efficacy of pain relief with other formulations while it may be superior to others in term of compliance and safety. CONCLUSION: This meta-analysis indicates that gabapentin is an effective and well-tolerated treatment for patients with PHN. SN - 1827-1596 UR - https://www.unboundmedicine.com/medline/citation/24257149/Efficacy_and_safety_of_gabapentin_for_treatment_of_postherpetic_neuralgia:_a_meta_analysis_of_randomized_controlled_trials_ L2 - http://www.minervamedica.it/index2.t?show=R02Y2014N05A0556 DB - PRIME DP - Unbound Medicine ER -