Gabapentin for Neuropathic Cancer Pain: A Randomized Controlled Trial From the Gabapentin Cancer Pain Study Group
| Autor: | Ricardo Yaya Tur, Marco Visentin, Giovanna Gorni, Cesare Bonezzi, Ernesto Zecca, Massimo Barbieri, Edoardo Arcuri, Franco De Conno, Cinzia Martini, Walter Tirelli, Augusto Caraceni, Marco Maltoni |
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| Rok vydání: | 2004 |
| Předmět: |
Male
Cancer Research Cyclohexanecarboxylic Acids Gabapentin medicine.medical_treatment Nervous System Neoplasms Pain Acetates law.invention Double-Blind Method Randomized controlled trial law Humans Medicine Neoplasm Invasiveness Amines gamma-Aminobutyric Acid Aged Pain Measurement Burning Pain Analgesics business.industry Nerve Compression Syndromes Middle Aged Analgesics Opioid Treatment Outcome Allodynia Anticonvulsant Oncology Opioid Anesthesia Neuropathic pain Female medicine.symptom business Cancer pain medicine.drug |
| Zdroj: | Journal of Clinical Oncology. 22:2909-2917 |
| ISSN: | 1527-7755 0732-183X |
| Popis: | Purpose To determine the analgesic effect of the addition of gabapentin to opioids in the management of neuropathic cancer pain. Patients and Methods One hundred twenty-one consecutive patients with neuropathic pain due to cancer, partially controlled with systemic opioids, participated in a multicenter, randomized, double-blind, placebo-controlled, parallel-design, 10-day trial from August 1999 to May 2002. Gabapentin was titrated from 600 mg/d to 1,800 mg/d in addition to stable opioid dose. Extra opioid doses were available as needed. Zero to 10 numerical scale was used to rate average daily pain. The average pain score over the whole follow-up period was used as main outcome measure. Secondary outcome measures were: intensity of burning pain, shooting/lancinating pain, dysesthesias (also scored on 0 to 10 numerical scale), number of daily episodes of lancinating pain, presence of allodynia, and daily extra doses of opiod analgesics. Results Overall, 79 patients received gabapentin and 58 (73%) completed the study; 41 patients received placebo and 31 (76%) completed the study. Analysis of covariance (ANCOVA) on the intent-to-treat population showed a significant difference of average pain intensity between gabapentin (pain score, 4.6) and placebo group (pain score, 5.4; P = .0250). Among secondary outcome measures, dysesthesia score showed a statistically significant difference (P = .0077; ANCOVA on modified intent-to-treat population = 115 patients with at least 3 days of pain assessments). Reasons for withdrawing patients from the trial were adverse events in six patients (7.6%) receiving gabapentin and in three patients receiving placebo (7.3%). Conclusion Gabapentin is effective in improving analgesia in patients with neuropathic cancer pain already treated with opioids. |
| Databáze: | OpenAIRE |
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