Short-term outcomes of mirogabalin in patients with peripheral neuropathic pain: a retrospective study

Abstract

Background: Mirogabalin, which is approved for the treatment of peripheral neuropathic pain in Japan, is a ligand for the α2δ subunit of voltage-gated calcium channels. Both pregabalin and mirogabalin act as nonselective ligands at the α2δ-1 and α2δ-2 subunits. Mirogabalin has a unique binding profile and long duration of action. Pregabalin has been reported to produce intolerable adverse effects in some patients. This study investigated outcomes associated with mirogabalin administration in patients with peripheral neuropathic pain who ceased treatment with pregabalin. Methods: We retrospectively assessed peripheral neuropathic pain using the neuropathic pain screening questionnaire (NeP score) in 187 patients (58 men, 129 women) who were treated with mirogabalin. All patients had switched from pregabalin to mirogabalin due to lack of efficacy or adverse events. Differences in the treatment course (i.e., numeric rating scale (NRS) scores) were compared using one-way analysis of variance with Bonferroni post hoc tests. Results: The mean age of the patients was 72.3 years (range, 30-94 years), and the mean duration of disease was 37 months (range, 3-252 months). After treatment with mirogabalin for 1 week, NRS scores significantly decreased compared with baseline and continued to decrease over time. After 8 weeks, NRS scores improved by ≥ 30% from baseline in 113 patients (69.3%). Twenty-four patients (12.8%) stopped mirogabalin treatment due to adverse events. Somnolence (26.7%), dizziness (12.3%), edema (5.9%), and weight gain (0.5%) were noted as adverse events of mirogabalin. Conclusions: The results of this investigation indicate that mirogabalin is safe and effective for reducing peripheral neuropathic pain.

Ultrasound-guided parasternal intercostal nerve block for postoperative analgesia in mediastinal mass resection by median sternotomy: a randomized, double-blind, placebo-controlled trial

“…Pain scores (0–10) at rest and upon coughing were recorded by the research staff (H.C.) using the numerical rating scale (NRS) [ 18 ] at 1, 3, 6, 12, and 24 h after surgery, respectively.…”

The Evidence for Effective Inhibition of INa Produced by Mirogabalin ((1R,5S,6S)-6-(aminomethyl)-3-ethyl-bicyclo [3.2.0] hept-3-ene-6-acetic acid), a Known Blocker of CaV Channels

“…Mirogabalin (MGB, DS-5565, Tarlige ® , (1R,5S,6S)-6-(aminomethyl)-3-ethyl-bicyclo [3.2.0]hept-3-ene-6-acetic acid), an orally administered gabapentinoid, is a novel, preferentially selective ligand for the α 2 δ-1 subunit of voltage-gated Ca 2+ (Ca V ) channels, and has been used in trials for investigations in the treatment of post-herpetic neuralgia, pain associated with fibromyalgia, and diabetic peripheral neuropathic pain [ 1 , 2 , 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 ]. Owing to the considerable research effort, this compound is being investigated for the treatment of peripheral neuropathic pain and fibromyalgia and has demonstrated promising results in patients with diabetic peripheral neuropathy [ 2 , 3 , 4 , 5 , 6 , 9 , 11 , 14 , 15 ]. Moreover, it has recently been shown to be effective in alleviating anxiety, and in improving cognitive impairments in rats injected repeatedly and intramuscularly with acidic saline [ 12 , 13 , 17 ].…”

Mirogabalin—A Novel Selective Ligand for the α2δ Calcium Channel Subunit

“…In 2020, Tetsunaga et al [ 39 ] investigated the outcomes of mirogabalin administration in patients with peripheral neuropathic pain who terminated treatment with pregabalin due to the lack of efficacy or adverse events. Depending on pain symptoms and age of patient, the dose of mirogabalin was reduced or increased as required to between 2.5 and 15 mg twice daily.…”