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Prediction of pregabalin-mediated pain response by severity of sleep disturbance in patients with painful diabetic neuropathy and post-herpetic neuralgia.
Pain Med. 2014 Apr; 15(4):661-70.PM

Abstract

OBJECTIVE

To evaluate the predictive value of disturbed sleep on the ability of pregabalin to reduce pain associated with diabetic peripheral neuropathy (DPN) and post-herpetic neuralgia (PHN).

DESIGN

A post-hoc analysis of data pooled from 16 placebo-controlled trials of pregabalin in patients with DPN or PHN.

METHODS

Pain relief at endpoint was compared in patients with mild, moderate, or severe levels of baseline sleep disturbance. Sleep disturbance was based on a scale from 0-10 and scores <4, 4 to 7, and ≥7 were classified as mild, moderate, and severe, respectively.

RESULTS

Pregabalin significantly reduced mean pain scores in the DPN (N = 3,056) and PHN (N = 1,471) cohorts (mean placebo-adjusted reductions were -0.73 and -1.08 for patients with DPN/PHN, respectively; both P < 0.05). The greatest extent of pain relief occurred in patients with severe sleep interference scores at baseline. Data analyses using the pooled DPN/PHN population identified a subset of patients (N = 707) exhibiting marked levels of pain relief at endpoint (mean placebo-adjusted reduction of -2.88), all of whom had severe sleep interference scores at baseline. Baseline sleep interference scores were a moderately good predictor of global patient improvement in response to pregabalin treatment in both patient cohorts. Finally, path analysis showed a high degree of association between improvements in sleep and pain relief in patients with DPN/PHN.

CONCLUSION

Overall, these data suggest that the presence of comorbid sleep disturbance in patients with DPN/PHN might, in part, predict substantial pain relief in response to pregabalin treatment.

Authors+Show Affiliations

Eastern Virginia Medical School, Norfolk, Virginia, USA.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

24330406

Citation

Vinik, Aaron, et al. "Prediction of Pregabalin-mediated Pain Response By Severity of Sleep Disturbance in Patients With Painful Diabetic Neuropathy and Post-herpetic Neuralgia." Pain Medicine (Malden, Mass.), vol. 15, no. 4, 2014, pp. 661-70.
Vinik A, Emir B, Parsons B, et al. Prediction of pregabalin-mediated pain response by severity of sleep disturbance in patients with painful diabetic neuropathy and post-herpetic neuralgia. Pain Med. 2014;15(4):661-70.
Vinik, A., Emir, B., Parsons, B., & Cheung, R. (2014). Prediction of pregabalin-mediated pain response by severity of sleep disturbance in patients with painful diabetic neuropathy and post-herpetic neuralgia. Pain Medicine (Malden, Mass.), 15(4), 661-70. https://doi.org/10.1111/pme.12310
Vinik A, et al. Prediction of Pregabalin-mediated Pain Response By Severity of Sleep Disturbance in Patients With Painful Diabetic Neuropathy and Post-herpetic Neuralgia. Pain Med. 2014;15(4):661-70. PubMed PMID: 24330406.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Prediction of pregabalin-mediated pain response by severity of sleep disturbance in patients with painful diabetic neuropathy and post-herpetic neuralgia. AU - Vinik,Aaron, AU - Emir,Birol, AU - Parsons,Bruce, AU - Cheung,Raymond, Y1 - 2013/12/11/ PY - 2013/12/17/entrez PY - 2013/12/18/pubmed PY - 2015/1/6/medline KW - Diabetic Peripheral Neuropathy KW - Pain Response KW - Post-Herpetic Neuralgia KW - Predict KW - Pregabalin KW - Sleep Disturbance SP - 661 EP - 70 JF - Pain medicine (Malden, Mass.) JO - Pain Med VL - 15 IS - 4 N2 - OBJECTIVE: To evaluate the predictive value of disturbed sleep on the ability of pregabalin to reduce pain associated with diabetic peripheral neuropathy (DPN) and post-herpetic neuralgia (PHN). DESIGN: A post-hoc analysis of data pooled from 16 placebo-controlled trials of pregabalin in patients with DPN or PHN. METHODS: Pain relief at endpoint was compared in patients with mild, moderate, or severe levels of baseline sleep disturbance. Sleep disturbance was based on a scale from 0-10 and scores <4, 4 to 7, and ≥7 were classified as mild, moderate, and severe, respectively. RESULTS: Pregabalin significantly reduced mean pain scores in the DPN (N = 3,056) and PHN (N = 1,471) cohorts (mean placebo-adjusted reductions were -0.73 and -1.08 for patients with DPN/PHN, respectively; both P < 0.05). The greatest extent of pain relief occurred in patients with severe sleep interference scores at baseline. Data analyses using the pooled DPN/PHN population identified a subset of patients (N = 707) exhibiting marked levels of pain relief at endpoint (mean placebo-adjusted reduction of -2.88), all of whom had severe sleep interference scores at baseline. Baseline sleep interference scores were a moderately good predictor of global patient improvement in response to pregabalin treatment in both patient cohorts. Finally, path analysis showed a high degree of association between improvements in sleep and pain relief in patients with DPN/PHN. CONCLUSION: Overall, these data suggest that the presence of comorbid sleep disturbance in patients with DPN/PHN might, in part, predict substantial pain relief in response to pregabalin treatment. SN - 1526-4637 UR - https://www.unboundmedicine.com/medline/citation/24330406/Prediction_of_pregabalin_mediated_pain_response_by_severity_of_sleep_disturbance_in_patients_with_painful_diabetic_neuropathy_and_post_herpetic_neuralgia_ L2 - https://academic.oup.com/painmedicine/article-lookup/doi/10.1111/pme.12310 DB - PRIME DP - Unbound Medicine ER -