Efficacy and Safety of Pregabalin for the Treatment of Neuropathic Pain in Patients Undergoing Hemodialysis

Otsuki, Tomoyasu; Higuchi, Terumi; Yamazaki, Toshio; Okawa, Erina; Okada, Kazuyoshi; Abe, Masanori

doi:10.1007/s40261-016-0464-1

Cited by 10 publications

(14 citation statements)

References 27 publications

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“…Details of the 40 included studies 14-53 are reported in Table 2 and include data from 963 269 patients from 21 countries. Out of the 40 studies, 17 included a prevalence measure of overall analgesic use, 14,16-18,20,23,25,29,33,36,37,43,45,46,48,49,52 33 included a prevalence measure of one or more specific analgesic drug class, defined as opioid, NSAID, adjuvant, and nonopioid, 14-24,…”

Section: Resultsmentioning

confidence: 99%

“…Out of the 40 studies, 17 included a prevalence measure of overall analgesic use, 14,[16][17][18]20,23,25,29,33,36,37,43,45,46,48,49,52 33 included a prevalence measure of one or more specific analgesic drug class, defined as opioid, NSAID, adjuvant, and nonopioid, [14][15][16][17][18][19][20][21][22][23][24][26][27][28][30][31][32][33][34][35][36][37][38][39][40][41][42][43][44][45][46][47]50 and 18 measured the prevalence of one or more specific analgesic drug, including acetaminophen.…”

Section: Details Of Included Studiesmentioning

confidence: 99%

“…Three prevalence groupings were extracted that had sufficient data to complete full meta-analyses: overall analgesic use prevalence (17 studies), 14,[16][17][18]20,23,25,29,33,36,37,43,45,46,48,49,52 opioid use prevalence (13 studies), [14][15][16]18,19,21,24,26,31,37,38,40,44 and NSAID use prevalence (19 studies). 14,15,19,20,22,[26][27][28]30,32,34,35,37,[39][40][41][42]47,50 A meta-analysis was also done for acetaminophen use, which included 8 studies, 14,…”

Section: Details Of Included Studiesmentioning

confidence: 99%

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Analgesic Use in Patients With Advanced Chronic Kidney Disease: A Systematic Review and Meta-Analysis

Rathwell

George

Hussain

et al. 2020

Can J Kidney Health Dis

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Background: Pain is common in patients with chronic kidney disease (CKD). Analgesics may be appropriate for some CKD patients. Objectives: To determine the prevalence of overall analgesic use and the use of different types of analgesics including acetaminophen, nonsteroidal anti-inflammatory drugs (NSAIDs), adjuvants, and opioids in patients with CKD. Design: Systematic review and meta-analysis. Setting: Interventional and observational studies presenting data from 2000 or later. Exclusion criteria included acute kidney injury or studies that limited the study population to a specific cause, symptom, and/or comorbidity. Patients: Adults with stage 3-5 CKD including dialysis patients and those managed conservatively without dialysis. Measurements: Data extracted included title, first author, design, country, year of data collection, publication year, mean age, stage of CKD, prevalence of analgesic use, and the types of analgesics prescribed. Methods: Databases searched included MEDLINE, CINAHL, EMBASE, and Cochrane Library. Two reviewers independently screened all titles and abstracts, assessed potentially relevant articles, and extracted data. We estimated pooled prevalence of analgesic use and the I2 statistic was computed to measure heterogeneity. Random-effects models were used to account for variations in study design and sample populations, and a double arcsine transformation of the prevalence variables was used to accommodate potential overweighting of studies with very large or very small prevalence measurements. Sensitivity analyses were performed to determine the magnitude of publication bias and assess possible sources of heterogeneity. Results: Forty studies were included in the analysis. The prevalence of overall analgesic use in the random-effects model was 50.8%. The prevalence of acetaminophen, NSAIDs, and adjuvant use was 27.5%, 17.2%, and 23.4%, respectively, while the prevalence of opioid use was 23.8%. Due to the possibility of publication bias, the actual prevalence of acetaminophen use in patients with advanced CKD may be substantially lower than this meta-analysis indicates. A trim-and-fill analysis decreased the pooled prevalence estimate of acetaminophen use to 5.4%. The prevalence rate for opioid use was highly influenced by 2 large US studies. When these were removed, the estimated prevalence decreased to 17.3%. Limitations: There was a lack of detailed information regarding the analgesic regimen (such as specific analgesics used within each class and inconsistent accounting for patients on multiple drugs and the use of over-the-counter analgesics such as acetaminophen and NSAIDs), patient characteristics, type of pain being treated, and the outcomes of treatment. Data on adjuvant use were very limited. These results, therefore, must be interpreted with caution. Conclusions: There was tremendous variability in the prescribing patterns of both nonopioid and opioid analgesics within and between countries suggesting widespread uncertainty about the optimal pharmacological approach to treating pain. Further research that incorporates robust reporting of analgesic regimens and links prescribing patterns to clinical outcomes is needed to guide optimal clinical practice.

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Section: Resultsmentioning

confidence: 99%

Section: Details Of Included Studiesmentioning

confidence: 99%

Section: Details Of Included Studiesmentioning

confidence: 99%

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Analgesic Use in Patients With Advanced Chronic Kidney Disease: A Systematic Review and Meta-Analysis

Rathwell

George

Hussain

et al. 2020

Can J Kidney Health Dis

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“…Common side effects include dizziness, somnolence, dry mouth, and constipation. 136,137 Gabapentin is initiated as a single 600 mg dose on day 1 and increased every 3 days to a dose of 1800 mg, divided in 3 doses. The maximum analgesic dose of gabapentin recommended for adults is usually between 1,800 and 3,600 mg per day.…”

Section: Management Of Patients With Neuropathic Corneal Painmentioning

confidence: 99%

Neuropathic Corneal Pain

2017

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Neuropathic pain is caused by a primary lesion or dysfunction of the nervous system and can occur in the cornea. However, neuropathic corneal pain (NCP) is currently an ill-defined disease. Patients with NCP are extremely challenging to manage and evidence-based clinical recommendations for the management of patients with NCP are scarce. The objectives of this review are to provide guidelines for diagnosis and treatment of patients with NCP and to summarize current evidence-based literature in this area. We performed a systematic literature search of all relevant publications between 1966 and 2017. Treatment recommendations are, in part, based on methodologically sound randomized controlled trials (RCTs), demonstrating superiority to placebo or relevant control treatments, and on the consistency of evidence, degree of efficacy, and safety. In addition, the recommendations include our own extensive experience in the management of these patients over the past decade. A comprehensive algorithm, based on clinical evaluation and complementary tests, is presented for diagnosis and subcategorization of patients with NCP. Recommended first-line topical treatments include neuro-regenerative and anti-inflammatory agents, whilst first-line systemic pharmacotherapy includes tricyclic antidepressants and the anticonvulsant. Second line oral treatments recommended include the opioid-antagonist and opiate analgesics. Complementary and alternative treatments, such as cardio-exercise, acupuncture, omega-3 fatty acid, and gluten-free diet, may have additional benefits, as do potential non-invasive and invasive procedures in recalcitrant cases. Medication selection should be tailored on an individual basis, considering side effects, comorbidities, and levels of peripheral and centralized pain. Nevertheless, there is an urgent need for long-term studies and RCTs assessing the efficacy of treatments for NCP.

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“…Pregabalin has been investigated for use in cancer-induced bone pain [74] and as a premedication to provide postoperative analgesia [75, 76]. Pregabalin can be an effective treatment for peripheral neuropathic pain provided adverse reactions are carefully monitored and dosages are correctly determined [77]. It demonstrates good bioavailability (≈98 %), minimal drug interactions, and low protein binding [78].…”

Section: Newer Antiepileptic Drugsmentioning

confidence: 99%

An Updated Overview on Therapeutic Drug Monitoring of Recent Antiepileptic Drugs

2016

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Given the distinctive characteristics of both epilepsy and antiepileptic drugs (AEDs), therapeutic drug monitoring (TDM) can make a significant contribution to the field of epilepsy. The measurement and interpretation of serum drug concentrations can be of benefit in the treatment of uncontrollable seizures and in cases of clinical toxicity; it can aid in the individualization of therapy and in adjusting for variable or nonlinear pharmacokinetics; and can be useful in special populations such as pregnancy. This review examines the potential for TDM of newer AEDs such as eslicarbazepine acetate, felbamate, gabapentin, lacosamide, lamotrigine, levetiracetam, perampanel, pregabalin, rufinamide, retigabine, stiripentol, tiagabine, topiramate, vigabatrin, and zonisamide. We describe the relationships between serum drug concentration, clinical effect, and adverse drug reactions for each AED as well as the different analytical methods used for serum drug quantification. We discuss retrospective studies and prospective data on the serum drug concentration–efficacy of these drugs and present the pharmacokinetic parameters, oral bioavailability, reference concentration range, and active metabolites of newer AEDs. Limited data are available for recent AEDs, and we discuss the connection between drug concentrations in terms of clinical efficacy and nonresponse. Although we do not propose routine TDM, serum drug measurement can play a beneficial role in patient management and treatment individualization. Standardized studies designed to assess, in particular, concentration–efficacy–toxicity relationships for recent AEDs are urgently required.

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Efficacy and Safety of Pregabalin for the Treatment of Neuropathic Pain in Patients Undergoing Hemodialysis

Abstract: UMIN000023117.

Cited by 10 publications

References 27 publications

Analgesic Use in Patients With Advanced Chronic Kidney Disease: A Systematic Review and Meta-Analysis

Analgesic Use in Patients With Advanced Chronic Kidney Disease: A Systematic Review and Meta-Analysis

Neuropathic Corneal Pain

An Updated Overview on Therapeutic Drug Monitoring of Recent Antiepileptic Drugs

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