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. 2019 May 15;10:504.
doi: 10.3389/fphar.2019.00504. eCollection 2019.

The Effect of Once-Daily Gabapentin Extended Release Formulation in Patients With Postamputation Pain

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Free PMC article

The Effect of Once-Daily Gabapentin Extended Release Formulation in Patients With Postamputation Pain

Nebojsa Nick Knezevic et al. Front Pharmacol. .
Free PMC article

Abstract

Objectives: To compare gabapentin extended-release, a gastro-retentive formulation, in relieving postamputation pain among gabapentin-experienced and gabapentin-naïve patients.

Design: Open-labeled pilot study.

Subjects: Sixteen patients with postamputation pain (8 patients in the gabapentin-experienced and 8 patients in the gabapentin-naïve groups).

Methods: Patients were started on gabapentin extended-release and were followed up for 8 weeks. Patients reported their pain severity during rest and movement using a numeric rating scale (NRS), interference of pain with daily activities using the modified brief pain inventory (MBPI) questionnaire, and treatment satisfaction using the treatment satisfaction questionnaire for medication (TSQM).

Results: Patients from both gabapentin-experienced and gabapentin-naïve groups achieved a significant and sustainable pain relief over the course of therapy. The pain scores at rest decreased in both gabapentin-experienced and gabapentin-naïve groups from 5.88 ± 1.36 and 4.88 ± 2.95 to 1.88 ± 0.99 and 1.38 ± 1.51, respectively. An average percent of pain relief with gabapentin extended-release was noted to be significant (p < 0.01) after 8 weeks of therapy among gabapentin-experienced (81.25 ± 16.42%) and gabapentin-naïve groups (85 ± 17.73%) when compared to baseline for gabapentin-experienced (31.25 ± 29%) and gabapentin-naïve groups (36.25 ± 34.2%), respectively. Gabapentin-experienced and gabapentin-naïve groups had no significant difference in global satisfaction from treatment (79.14 ± 10.47 and 83.3 ± 20.82), convenience of treatment (73.78 ± 19.04 and 90.44 ± 11.66), effectiveness of treatment (72.6 ± 10.1 and 79.73 ± 11.6). The only statistically significant difference among gabapentin-experienced and gabapentin-naïve groups was found in adverse event tolerability (65.78 ± 10.36 and 85.8 ± 10.14, p < 0.01).

Conclusion: Once-daily dosing of gabapentin-extended release showed significant improvement in pain severity and functional status, with no difference found between gabapentin-experienced versus gabapentin-naïve patients.

Keywords: amputation; chronic pain; extended release; gabapentin; postamputation pain.

Figures

FIGURE 1
FIGURE 1
Gabapentin extended-release (ER) titration schedule and clinic visit intervals over the course of the study. The first visit was conducted prior to starting gabapentin ER medication. Patients were instructed to take 300 mg at night, then 600 mg dose on day 2, and 900 mg on day 3 which was continued until day 6. Dosage was increased to 1200 mg on day 7 (visit 2), followed by increase to 1500 mg on day 11, and to 1800 mg (max dose) on day 15, after their visit 3. Visit 4 occurred at week 4, visit 5 at week 8 and visit 6 at week 10.
FIGURE 2
FIGURE 2
Line graph showing pain at rest using numeric rating scale (NRS) over the course of the study.
FIGURE 3
FIGURE 3
Line graph showing pain during movement using numeric rating scale (NRS) over the course of the study.
FIGURE 4
FIGURE 4
Bar graph showing difference in pre-treatment and post treatment, (A) pain interference between gabapentin naïve vs. gabapentin experienced patients who completed the study, (B) pain relief with medication.
FIGURE 5
FIGURE 5
Bar graph showingfour aspects of treatment satisfaction questionnaire for medication (TSQM) in gabapentin-naïve vs. gabapentin-experienced patients who completed the study. *Statistical significant.

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