Response of Primary Erythromelalgia to Pregabalin Therapy

Kalava, Kalyan; Roberts, Charles; Adair, Jefferey D.; Raman, Vidya

doi:10.1097/rhu.0b013e31829cf8a2

Cited by 12 publications

(2 citation statements)

References 11 publications

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“…Common side effects are dizziness, somnolence, dry mouth, and weight gain. The case reports show that this has been used in EM with limited success 57,58. Both agents are started at a low dose and titrated to effect.…”

Section: Pharmacotherapymentioning

confidence: 99%

Current pain management strategies for patients with erythromelalgia: a critical review

Tham¹,

Giles²

2018

JPR

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Erythromelalgia (EM) is a rare disorder characterized by erythematous, warm, painful extremities, which is often precipitated by cold conditions. The pathophysiology of EM is incompletely understood. Recent investigations have identified sodium channelopathy as a genetic cause for this pain condition, classified as primary inherited EM. Other subtypes are idiopathic EM and secondary EM. The management of pain in EM is challenging as no single therapy has been found to be effective. There is varying response to pharmacotherapy and significant variability within this clinical population, resulting in a stepwise trial and error approach. Consequently, EM is often associated with poorer health-related quality of life with higher morbidity. There is currently no consensus or guidelines on management of pain in EM. This is a review of the literature on management of pain using pharmacologic, procedural intervention and nonpharmacologic treatment in children and adults with EM.

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Section: Pharmacotherapymentioning

confidence: 99%

Current pain management strategies for patients with erythromelalgia: a critical review

Tham¹,

Giles²

2018

JPR

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“…Case reports of treatment with propranolol, epinephrine, biofeedback, sodium nitroprusside, gabapentin, 13 pregabalin, 14 and typhoid vaccine appear in the literature, as do case series with high-dose magnesium, intravenous bupivacaine, the lidocaine patch, and lidocaine and mexiletine. Case reports of treatment with propranolol, epinephrine, biofeedback, sodium nitroprusside, gabapentin, 13 pregabalin, 14 and typhoid vaccine appear in the literature, as do case series with high-dose magnesium, intravenous bupivacaine, the lidocaine patch, and lidocaine and mexiletine.…”

Section: Pharmacologic Therapymentioning

confidence: 99%

House–Senate Committee Reaches Compromise on Compounding Bill

2013

Topics in Pain Management

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Topically Applied Midodrine, 0.2%, an α₁-Agonist, for the Treatment of Erythromelalgia

et al. 2015

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Letters RESEARCH LETTERTopically Applied Midodrine, 0.2%, an α 1 -Agonist, for the Treatment of ErythromelalgiaWe report the response of patients with erythromelalgia to topical midodrine hydrochloride, an α 1 -agonist. Erythromelalgia is a rare syndrome characterized by red, hot, painful feet and hands, sometimes extending proximally. Episodes are generally intermittent, lasting from minutes to hours, but can be continuous. 1 Although numerous therapeutic regimens have been described, 2 none is universally effective. Since symptoms are generally localized, topical treatments might be preferable to avoid systemic adverse effects. [3][4][5] Among the proposed mechanisms for erythromelalgia is local vasodilatation since increased blood flow has been observed in Doppler studies. During symptoms, we have noted that the mean temperature of the toe skin increased by 7.8°C, and blood flow increased 10.2-fold. 1,4 Because vasodilatation may account for the flushing during an episode, the use of a vasoconstrictor seems reasonable. We hypothesized that midodrine, a vasoactive drug that causes vasoconstriction, might be effective. Midodrine, a peripherally acting α 1 -agonist, activates the α-adrenergic receptors of vessels, resulting in increased vascular tone and reduced blood volume. A patient with erythromelalgia responding to oral midodrine has been reported. 6 We used a topical preparation of midodrine for the management of erythromelalgia. We then reviewed reported outcomes among patients with erythromelalgia who received treatment with topically applied midodrine, 0.2%.Methods | This study was conducted from November 1, 2011, to November 1, 2013, and was approved by the Mayo Clinic Institutional Review Board. Participants were patients in the Department of Dermatology at Mayo Clinic in Rochester, Minnesota, and provided written informed consent. The clinical diagnosis was erythromelalgia; midodrine, 0.2%, was to be applied topically, and patients were available for follow-up. Erythromelalgia was defined as the occurrence of red, hot, painful feet or hands. Midodrine, 0.2%, in a moisturizing skin cream (Vanicream) was compounded at the Mayo Clinic pharmacy and applied topically 3 times daily during symptoms.

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Response of Primary Erythromelalgia to Pregabalin Therapy

Cited by 12 publications

References 11 publications

Current pain management strategies for patients with erythromelalgia: a critical review

Current pain management strategies for patients with erythromelalgia: a critical review

House–Senate Committee Reaches Compromise on Compounding Bill

Topically Applied Midodrine, 0.2%, an α₁-Agonist, for the Treatment of Erythromelalgia

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Response of Primary Erythromelalgia to Pregabalin Therapy

Cited by 12 publications

References 11 publications

Current pain management strategies for patients with erythromelalgia: a critical review

Current pain management strategies for patients with erythromelalgia: a critical review

House–Senate Committee Reaches Compromise on Compounding Bill

Topically Applied Midodrine, 0.2%, an α1-Agonist, for the Treatment of Erythromelalgia

Contact Info

Product

Resources

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Topically Applied Midodrine, 0.2%, an α₁-Agonist, for the Treatment of Erythromelalgia