Pregabalin vs placebo to prevent chronic pain after whiplash injury in at-risk individuals: results of a feasibility study for a large randomised controlled trial
| Autor: | Jane Nikles, Siegfried Perez, Stephan A. Schug, Luke B. Connelly, Scott F. Farrell, Michele Sterling, Samuel A. McLean, Geoffrey Mitchell, Robert S. Ware, Gerben Keijzers |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Pregabalin Placebo law.invention Double-Blind Method Randomized controlled trial Rating scale law Internal medicine medicine Humans Adverse effect Whiplash Injuries Pain Measurement Analgesics Neck pain business.industry Chronic pain medicine.disease Whiplash injury Treatment Outcome Anesthesiology and Pain Medicine Neurology Feasibility Studies Neurology (clinical) Chronic Pain medicine.symptom business medicine.drug |
| Zdroj: | Pain. 163:e274-e284 |
| ISSN: | 1872-6623 0304-3959 |
| DOI: | 10.1097/j.pain.0000000000002362 |
| Popis: | There are few effective treatments for acute whiplash-associated disorders (WADs). Early features of central sensitisation predict poor recovery. The effect of pregabalin on central sensitisation might prevent chronic pain after acute whiplash injury. This double blind, placebo-controlled randomised controlled trial examined feasibility and potential effectiveness of pregabalin compared with placebo for people with acute WAD. Twenty-four participants with acute WAD (48 hours) and at risk of poor recovery (pain ≥5/10) were recruited from hospital emergency departments in Queensland, Australia, and randomly assigned by concealed allocation to either pregabalin (n = 10) or placebo (n = 14). Pregabalin was commenced at 75 mg bd, titrated to 300 mg bd for 4 weeks, and then weaned over 1 week. Participants were assessed at 5 weeks and 3, 6, and 12 months. Feasibility issues included recruitment difficulties and greater attrition in the placebo group. For the primary clinical outcome of neck pain intensity, attrition at 5 weeks was pregabalin: 10% and placebo: 36% and at 12 months was pregabalin: 10% and placebo: 43%. Pregabalin may be more effective than placebo for the primary clinical outcome of neck pain intensity at 3 months (mean difference: -4.0 [95% confidence interval -6.2 to -1.7]) on an 11-point Numerical Rating Scale. Effects were maintained at 6 months but not 12 months. There were no serious adverse events. Minor adverse events were more common in the pregabalin group. A definitive large randomised controlled trial of pregabalin for acute whiplash injury is warranted. Feasibility issues would need to be addressed with modifications to the protocol. |
| Databáze: | OpenAIRE |
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