Relationships Among Pain Quality, Pain Impact, and Overall Improvement in Patients with Postherpetic Neuralgia Treated with Gastroretentive Gabapentin

Freeman, Roy; Wallace, Mark; Sweeney, Michael; Backonja, M.

doi:10.1111/pme.12791

Cited by 9 publications

(5 citation statements)

References 36 publications

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“…Out of the selected 50 controlled trials, 29 investigated pregabalin [2,, 16 gabapentin [48][49][50][51][52][53][54][55][56][57][58][59][60][61][62][63], and 5 studies assessed pregabalin and gabapentin compared to placebo-controlled trials [64][65][66][67][68]. Half of the included studies were undertaken in USA [29, 33, 35, 36, 39, 42-48, 50-52, 55, 57-60, 62-66].…”

Section: Study Characteristicsmentioning

confidence: 99%

The safety and efficacy of gabapentinoids in the management of neuropathic pain: a systematic review with meta-analysis of randomised controlled trials

et al. 2023

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Background There are increasing concerns regarding the abusive potential of gabapentinoids putting at risk patients with neuropathic pain requiring long-term pain management. The evidence to support this is rather inconcusive. Aim This systematic review aimed to evaluate the safety and efficacy of gabapentinoids in the management of neuropathic pain with a focus on randomised controlled trials (RCTs) and categorising the side effects according to the body systems they were affecting. Method Searches were conducted in MEDLINE (PubMed), EMBASE, Web of Science, PsycoINFO, and CINAHL (EBSCO), and included RCTs to identify and critically appraise studies investigating safety and therapeutic effects of gabapentionoids in adults with neuropathic pain. Data extraction was conducted using an established Cochrane form and the risk-of-bias tool was used in the assessment of quality. Results 50 studies (12,398 participants) were included. The majority of adverse events pertained to the nervous system (7 effects) or psychiatric (3 effects) disorders. There were more adverse effects reported with pregabalin (36 effects) than with gabapentin (22 effects). Six pregabalin studies reported euphoria as a side effect, while no studies reported euphoria with gabapentin. This was the only side effect that may correlate with addictive potential. Gabapentioids were reported to significantly reduce pain compared to placebo. Conclusion Despite RCTs documenting the adverse events of gabapentionoids on the nervous system, there was no evidence of gabapentinoid use leading to addiction, suggesting an urgent need to design studies investigating their abusive potential.

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Section: Study Characteristicsmentioning

confidence: 99%

The safety and efficacy of gabapentinoids in the management of neuropathic pain: a systematic review with meta-analysis of randomised controlled trials

et al. 2023

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“…patients tested the effect of gabapentinoids on neuropathic pain related to different aetiologies, including diabetic polyneuropathy, postherpetic neuralgia, and radiotherapyrelated neuropathic pain (Table 2) [10][11][12][13][14][15][16][17][18].…”

Section: Gabapentinoids Nine Rcts Globally Involving 3903mentioning

confidence: 99%

Pharmacotherapeutic Options for Managing Neuropathic Pain: A Systematic Review and Meta-Analysis

Stefano

Lionardo

Pietro

et al. 2021

Pain Research and Management

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Despite an increasing number of available therapies, the treatment of neuropathic pain remains a major issue. Systematic reviews and meta-analyses indicate that only a minority of patients with neuropathic pain have an adequate response to pharmacological treatment and that most drugs have dose-limiting side effects. We conducted a systematic review and meta-analysis of randomised controlled trials published in the last five years. We searched for relevant papers within PubMed, EMBASE, the Cochrane Database of Systematic Reviews, and the Clinical Trials database (ClinicalTrials.gov). Two authors independently selected studies for inclusion, data extraction, and bias assessment. We identified 39 randomised controlled trials and included 16 in the meta-analysis. Trial outcomes were generally modest even for first-line drugs such as tricyclic antidepressants, serotonin-noradrenaline reuptake inhibitors, and gabapentinoids. Many drugs acting on new pain targets are currently under development. Clinical data are currently available for sodium channel isoform-specific antagonists, anti-nerve growth factor molecules, and fatty acid amide hydrolase inhibitors.

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“…23 Neuropathic pain, depression, and sleep interference associated with PHN improved in patients randomized to receive 1,800 to 3,600 mg daily of gabapentin as compared with placebo, although the gabapentin was associated with increased incidence of somnolence, dizziness, ataxia, peripheral edema, and infection. [24][25][26][27][28] Pregabalin, an analgesic, anxiolytic, and anticonvulsant agent, in doses of 150 to 600 mg daily offered similar pain and sleep improvement for those with PHN. 29,30…”

Section: Functionmentioning

confidence: 99%

“…Hyperbaric oxygen combined with standard-of-care anti-inflammatory and antiviral therapy improved HZ patient depression, pain, and healing time while reducing the likelihood of developing PHN compared with standard of care alone. 44 For those with PHN, the anticonvulsants gabapentin 24,27 or pregabalin 29 improved depression and pain. Chinese traditional medicine (eg, cupping and acupuncture) with local anesthetic injections improved pain, quality of life, and depression, but it was not possible to identify specific effects of the individual components of therapy.…”

Section: Depressionmentioning

confidence: 99%

Herpes Zoster (Shingles) Patient-Centered Wound Outcomes: A Literature Review

Bolton¹,

Faller²,

Kirsner

2021

Adv Skin Wound Care

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GENERAL PURPOSE To present a comprehensive review of patient-centered outcomes of topical or systemic interventions applied to those with shingles or postherpetic neuralgia to inform clinical practice and identify related research needs. TARGET AUDIENCE This continuing education activity is intended for physicians, physician assistants, nurse practitioners, and nurses with an interest in skin and wound care. LEARNING OBJECTIVES/OUTCOMES After participating in this educational activity, the participant will be able to: 1. Explain the importance of early diagnosis and treatment of herpes zoster (HZ). 2. Identify interventions that have resulted in documented improvement of validated patient-centered outcomes in patients with HZ or postherpetic neuralgia. 3. Recognize the average per patient medical costs of HZ in the US. BACKGROUND One in three people endure herpes zoster (HZ; also known as shingles) during their lifetime, experiencing pain, secondary infections, postherpetic neuralgia, reduced quality of life, and considerable patient costs. These patient burdens remain to be reviewed. OBJECTIVE To perform a comprehensive review of patient-centered outcomes of topical or systemic interventions applied to those with shingles or postherpetic neuralgia to inform clinical practice and identify related research needs. DATA SOURCES The PubMed database was searched with supplementary Google Scholar searches for Medical Subject Headings “shingles” or “post-herpetic neuralgia” to find clinical studies documenting validated patient-centered outcomes: pain, secondary infection, healing, function, depression, social isolation, treatment costs, or quality of life. Six representative case studies were examined. DATA SELECTION Pertinent original and derivative clinical study references were included. Preclinical studies, reviews, or studies of non-HZ conditions were excluded. DATA EXTRACTION Two authors tabulated clinical efficacy evidence for interventions affecting patient-centered outcomes. DATA SYNTHESIS Evidence supported efficacy for systemic antiviral or topical anesthetic interventions improving pain, healing, sleep, vision, or quality of life for those with HZ or postherpetic neuralgia. Patient cases reported improved pain and/or sleep using occlusive dressings. Treatment costs and secondary infections were reported only in cases or cohort studies. CONCLUSIONS Randomized clinical research focused on medications improving patient pain, healing, sleep, or vision outcomes. Research is needed measuring outcomes of adding occlusive dressings to optimal care and effects on secondary infections and treatment costs.

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Relationships Among Pain Quality, Pain Impact, and Overall Improvement in Patients with Postherpetic Neuralgia Treated with Gastroretentive Gabapentin

Cited by 9 publications

References 36 publications

The safety and efficacy of gabapentinoids in the management of neuropathic pain: a systematic review with meta-analysis of randomised controlled trials

The safety and efficacy of gabapentinoids in the management of neuropathic pain: a systematic review with meta-analysis of randomised controlled trials

Pharmacotherapeutic Options for Managing Neuropathic Pain: A Systematic Review and Meta-Analysis

Herpes Zoster (Shingles) Patient-Centered Wound Outcomes: A Literature Review

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