Somatosensory predictors of response to pregabalin in painful chemotherapy-induced peripheral neuropathy: a randomized, placebo-controlled, crossover study

Hincker, Alexander; Frey, Karen; Rao, Lesley K.; Wagner‐Johnston, Nina D.; Abdallah, Arbi Ben; Tan, Benjamin Kye Jyn; Amin, Manik; Wildes, Tanya M.; Shah, Rajiv; Karlsson, Páll; Bakos, K; Kosicka, Katarzyna; Kagan, Leonid; Haroutounian, Simon

doi:10.1097/j.pain.0000000000001577

Cited by 29 publications

(20 citation statements)

References 41 publications

(55 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Several drugs have been reported for treating CIPN. In these reports, calcium and magnesium, goshajinkigan, duloxetine, vitamin B12, pregabalin, and gabapentin were used [41][42][43][48][49][50][51][52][53][54][55][56][57][58][59][60][61][62]. However, calcium/magnesium, goshajinkigan, and gabapentin were found to be ineffective at treating CIPN in the largest double-blind randomized controlled trials (RCTs) for each drug.…”

Section: Discussionmentioning

confidence: 99%

Mirogabalin vs pregabalin for chemotherapy-induced peripheral neuropathy in pancreatic cancer patients

et al. 2021

View full text Add to dashboard Cite

Background The prognosis of pancreatic cancer (PC) has been improved by new chemotherapy regimens (combination of 5-fluorouracil, oxaliplatin, irinotecan, and leucovorin (FOLFIRINOX) or gemcitabine plus nab-paclitaxel (GnP)). Unfortunately, chemotherapy-induced peripheral neuropathy (CIPN) is a common adverse event of these two regimens. The efficacy of pregabalin for CIPN has been reported in previous studies. However, the efficacy of mirogabalin for CIPN remains unknown. Thus, in this study, we aimed to clarify which drug (mirogabalin or pregabalin) was more valuable for improving CIPN. Methods A total of 163 PC patients who underwent FOLFIRINOX or GnP between May 2014 and January 2021 were enrolled. Among them, 34 patients were diagnosed with CIPN. Thirteen patients were treated with mirogabalin (mirogabalin group), and twenty-one patients were treated with pregabalin (pregabalin group). Treatment efficacy was compared between the two groups. Results In both the mirogabalin group and the pregabalin group, the grade of patients with CIPN at 2, 4, and 6 weeks after the initiation of treatment showed significant improvement compared to the pretreatment grade. Notably, the rate of CIPN improvement was higher in the mirogabalin group than in the pregabalin group (2 weeks: 84.6% (11/13) vs 33.3% (7/21), P value = 0.005; 4 weeks, 6 weeks: 92.3% (12/13) vs 33.3% (7/21), P value = 0.001). Conclusions Although both mirogabalin and pregabalin were effective at improving CIPN, mirogabalin might be a suitable first choice for CIPN in PC patients. Trial registration Not applicable

show abstract

Section: Discussionmentioning

confidence: 99%

Mirogabalin vs pregabalin for chemotherapy-induced peripheral neuropathy in pancreatic cancer patients

et al. 2021

View full text Add to dashboard Cite

show abstract

“…On a larger scale, post hoc analysis of clinical trial data revealed that pregabalin had no benefit in patients with HIV neuropathy but provided pain relief in a patient subgroup characterized by severe pinprick hyperalgesia. 32 A more recent study of patients with chemotherapy-induced neuropathy found that mechanical pain thresholds were not predictive of response to pregabalin, though the number of patients exhibiting mechanical hypersensitivity was low, 33 and the former study noted that only those patients with the most severe pinprick hyperalgesia benefited, whereas those with mild/moderate hyperalgesia did not. Baron and colleagues proposed that these patients are represented by the mechanical cluster (Figure 1) and that central sensitization is the predominant pathophysiological mechanism.…”

Section: Calcium Channel Modulatorsmentioning

confidence: 98%

Translational issues in precision medicine in neuropathic pain

Dickenson

Patel

2020

Canadian Journal of Pain

View full text Add to dashboard Cite

Neuropathic pain remains poorly treated, with most new drugs falling through the translational gap. The traditional model of bench-to-bedside research has relied on identifying new mechanisms/targets in animal models and then developing clinical applications. Several have advocated bridging the translational gap by beginning with clinical observations and backtranslating to animal models for further investigation of mechanisms. There is good evidence that phenotyping of patients through quantitative sensory testing can lead to improved treatment selection and hence improved patient outcomes. This practice has been widely adopted in clinical investigations, but its application in preclinical research is not mainstream. In this review, we retrospectively examine our historical rodent data sets with the aim of reconsidering drug effects on sensory neuronal endpoints, their alignment with clinical observations, and how these might guide future clinical studies. RÉSUMÉLa douleur neuropathique reste mal traitée, alors que la plupart des nouveaux médicaments ne réussissent pas à franchir le fossé translationnel. Le modèle traditionnel de la recherche, du laboratoire au chevet du patient, repose sur l'identification de nouveaux mécanismes ou cibles dans des modèles animaux, suivie du développement d'applications cliniques. Certains préconisent de combler le fossé de la recherche translationnelle en commençant par des observations cliniques et en les transposant ensuite sur des modèles animaux afin d'approfondir l'étude des mécanismes. Il est bien établi que le phénotypage des patients par des tests sensoriels quantitatifs peut conduire à une meilleure sélection des traitements et, par conséquent, à de meilleurs résultats pour les patients. Ces pratiques ont été largement adoptées dans les enquêtes cliniques, mais leur application dans la recherche préclinique n'est pas généralisée. Dans cette revue, nous examinons rétrospectivement nos ensembles de données historiques sur les rongeurs dans le but de reconsidérer les effets des médicaments sur les paramètres neuronaux sensoriels, leur alignement avec les observations cliniques et la manière dont celles-ci pourraient orienter les études cliniques futures.

show abstract

“…The Patient Neurotoxicity Questionnaire (PNQ) scores in the pregabalin group were better than those in the duloxetine group (improving the PNQ scores : pregabalin : 90% vs duloxetine : 31%, p value < 0.001) 33) . Some adverse events were reported in the Drug treatment for CIPN above RCTs (somnolence 22.5 -88%, dizziness 17.5 -68%, ataxia 5.0%, and diplopia 2.5%) 32,37) .…”

Section: Pregabalinmentioning

confidence: 99%

Drug treatment for chemotherapy-induced peripheral neuropathy in patients with pancreatic cancer

Sugimoto

Takagi

Suzuki

et al. 2022

FJMS

View full text Add to dashboard Cite

Pancreatic cancer (PC) is a lethal disease where most tumors are too advanced at diagnosis for resection, leaving chemotherapy as the mainstay of treatment. Although the prognosis of unresectable PC is poor, it has been dramatically improved by new chemotherapy treatments, such as the combination of 5 -fluorouracil, oxaliplatin, irinotecan, and leucovorin (FOLFIRINOX) or gemcitabine plus nabpaclitaxel. However, as oxaliplatin and paclitaxel are common neurotoxic drugs, chemotherapyinduced peripheral neuropathy (CIPN) is a common and severe adverse effect of both treatments. As there are no agents recommended in the ASCO guidelines, we review the methods used to treat CIPN caused by PC treatment. The efficacy of duloxetine was observed in a large randomized controlled trial (RCT). In addition, pregabalin was more effective than duloxetine for CIPN in two RCTs. Although duloxetine and pregabalin can be effective for CIPN, they have several side effects. Therefore, the choice between the two drugs should be determined according to effect and tolerability. Mirogabalin is also used in patients with PC and there is hope it will yield positive outcomes when treating CIPN in the future.

show abstract

Somatosensory predictors of response to pregabalin in painful chemotherapy-induced peripheral neuropathy: a randomized, placebo-controlled, crossover study

Abstract: Supplemental Digital Content is Available in the Text. Baseline mechanical pain threshold does not predict analgesic response to pregabalin in painful chemotherapy-induced peripheral neuropathy caused by docetaxel, paclitaxel, or oxaliplatin.

Cited by 29 publications

References 41 publications

Mirogabalin vs pregabalin for chemotherapy-induced peripheral neuropathy in pancreatic cancer patients

Mirogabalin vs pregabalin for chemotherapy-induced peripheral neuropathy in pancreatic cancer patients

Translational issues in precision medicine in neuropathic pain

Drug treatment for chemotherapy-induced peripheral neuropathy in patients with pancreatic cancer

Contact Info

Product

Resources

About