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Pregabalin and gabapentin in neuropathic pain management after spinal cord injury: a systematic review and meta-analysis

Korean Journal of Pain 2020년 33권 1호 p.3 ~ 12
 ( Davari Majid ) - Tehran University of Medical Sciences Department of Pharmacoeconomics and Pharmaceutical Administration

 ( Amani Bahman ) - Tehran University of Medical Sciences School of Public Health Department of Health Management and Economics
 ( Amani Behnam ) - Tehran University of Medical Sciences School of Public Health Department of Health Management and Economics
 ( Khanijahani Ahmad ) - Duquesne University John G. Rangos School of Health Sciences Department of Health Administration and Public Health
 ( Akbarzadeh Arash ) - Tehran University of Medical Sciences School of Public Health Department of Biostatistics and Epidemiology
 ( Shabestan Rouhollah ) - Tehran University of Medical Sciences School of Public Health Department of Biostatistics and Epidemiology

Abstract


Neuropathic pain after spinal cord injury (SCI) has a significant negative impact on the patients’ quality of life. The objective of this systematic review is to examine the safety and efficacy of pregabalin (PGB) and gabapentin (GBP) in the treatment of neuropathic pain due to SCI. PubMed, the Cochrane Library, Embase, Scopus, and the Web of Science were searched up to December 2018. The reference lists of key and review studies were reviewed for additional citations. The quality of the studies was evaluated using the Cochrane Collaboration’s tools for assessing the risk of bias. A meta-analysis was performed for primary and secondary outcomes. Eight studies were eligible for inclusion. Meta-analysis of PGB vs. placebo showed that PGB was effective for neuropathic pain (standardized mean difference [SMD] = ?0.40; 95% confidence interval [CI]: ?0.78, ?0.01), anxiety (MD = ?0.68; 95% CI: ?0.77, ?0.59), depression (mean difference [MD] = ?0.99; 95% CI: ?1.08, ?0.89), and sleep interference (MD = ?1.08; 95% CI: ?1.13, ?1.02). Also, GBP was more effective than a placebo for reducing pain. No significant difference was observed between the efficacy of the two drugs (MD = ?0.37; 95% CI: ?1.67, 0.93). There was no significant difference between the two drugs for discontinuation due to adverse events (risk ratio = 3.00; 95% CI: 0.81, 11.15). PGB and GBP were effective vs. placebos in decreasing neuropathic pain after SCI. Also, there was no significant difference between the two drugs for decreasing pain and adverse events.

키워드

Anxiety; Depression; Gabapentin; Meta-Analysis; Neuralgia; Pain; Pregabalin; Spinal Cord Injuries; Systematic Review
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