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Multicenter Study
, 33 (9), 633-45

Effectiveness of Pregabalin as Monotherapy or Combination Therapy for Neuropathic Pain in Patients Unresponsive to Previous Treatments in a Spanish Primary Care Setting

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Multicenter Study

Effectiveness of Pregabalin as Monotherapy or Combination Therapy for Neuropathic Pain in Patients Unresponsive to Previous Treatments in a Spanish Primary Care Setting

Emilio Blanco Tarrio et al. Clin Drug Investig.

Erratum in

  • Clin Drug Investig. 2014 May;34(5):371

Abstract

Background and objective: Patients from a previous study of neuropathic pain (NP) in the Spanish primary care setting still had symptoms despite treatment. Subsequently, patients were treated as prescribed by their physician and followed up for 3 months. Since pregabalin has been shown to be effective in NP, including refractory cases, the objective of this study was to assess the effectiveness of pregabalin therapy in patients with NP refractory to previous treatments.

Methods: This was a post hoc analysis of pregabalin-naïve NP patients treated with pregabalin in a 3-month follow-up observational multicenter study to assess symptoms and satisfaction with treatment. Patients were evaluated with the Douleur Neuropathique en 4 questions (DN4), the Brief Pain Inventory (BPI) and the Treatment Satisfaction for Medication Questionnaire (SATMED-Q) overall satisfaction domain.

Results: 1,670 patients (mean age 58 years, 59 % women), previously untreated or treated with ≥1 drug other than pregabalin, were treated with pregabalin (37 % on monotherapy). At 3 months, pain intensity and its interference with activities decreased by half (p < 0.0001), while the number of days with no or mild pain increased by a mean of 4.5 days (p < 0.0001). Treatment satisfaction increased twofold (p < 0.0001). Patients with a shorter history of pain and those with neuralgia and peripheral nerve compression syndrome (PCS) as etiologies had the highest proportion on monotherapy and showed the greatest improvements in pain-related parameters in their respective group categories.

Conclusion: Treatment with pregabalin (as monotherapy or combination therapy) provides benefits in pain and treatment satisfaction in patients with NP, including refractory cases. Shorter disease progression and neuralgia and PCS etiologies are favorable factors for pregabalin treatment response.

Figures

Fig. 1
Fig. 1
Patient disposition in the previous and current study. DN4 Douleur Neuropathique en 4 questions, NP neuropathic pain
Fig. 2
Fig. 2
Progression of pain parameters and satisfaction with treatment during the study: a change in mean ± SD baseline-adjusted BPI-SF scores for pain intensity and pain interference with activities; b change in mean ± SD baseline-adjusted number of days with no or mild pain in the last week; c mean ± SD overall opinion score for satisfaction with treatment (SATMED-Q) at baseline and 3 months (baseline-adjusted); d mean ± SD overall opinion score for satisfaction with treatment (SATMED-Q) standardized for the Spanish population at baseline and 3 months. All p values vs. baseline. BPI-SF Brief Pain Inventory-Short Form, SATMED-Q Treatment Satisfaction for Medication Questionnaire, SD standard deviation
Fig. 3
Fig. 3
Pain outcomes according to disease progression: a change in mean baseline-adjusted BPI-SF scores for pain intensity and pain interference with activities; b change in mean baseline-adjusted number of days with no or mild pain; c responders to treatment; d change in baseline-adjusted overall opinion score for satisfaction with treatment (SATMED-Q); e mean baseline- and endpoint-adjusted overall opinion score for satisfaction with treatment (SATMED-Q) standardized for the Spanish population. p values represent among-group differences. BPI-SF Brief Pain Inventory-Short Form, SATMED-Q Treatment Satisfaction for Medication Questionnaire
Fig. 4
Fig. 4
Pain outcomes according to etiology: a change in mean baseline-adjusted BPI-SF scores for pain intensity and pain interference with activities; b change in mean baseline-adjusted number of days with no or mild pain; c responders to treatment. p values represent among-group differences. BPI-SF Brief Pain Inventory-Short Form, CRPS complex regional pain syndrome, PCS peripheral nerve compression syndrome, PLS phantom limb syndrome
Fig. 5
Fig. 5
Pain outcomes according to baseline BPI-SF pain intensity: a change in mean baseline-adjusted BPI-SF scores of pain intensity and pain interference with activities; b change in mean baseline-adjusted number of days with no or mild pain. p values represent among-group differences. BPI-SF Brief Pain Inventory-Short Form

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