Post hoc analysis of pregabalin vs. non-pregabalin treatment in patients with cancer-related neuropathic pain: better pain relief, sleep and physical health

• Published in: Clinical & translational oncology Vol. 13; no. 9; pp. 656 - 663
• Main Authors: Mañas, Ana, Ciria, Juan Pablo, Fernández, María Carmen, Gonzálvez, María Luisa, Morillo, Virginia, Pérez, María, Masramon, Xavier, López-Gómez, Vanessa
• Format: Journal Article
• Language: English
• Published: Milan Springer Milan 01-09-2011
• Subjects: Aged; Analgesia - methods; Analgesics - therapeutic use; Female; gamma-Aminobutyric Acid - analogs & derivatives; gamma-Aminobutyric Acid - therapeutic use; Humans; Male; Medicine; Medicine & Public Health; Middle Aged; Motor Activity - drug effects; Motor Activity - physiology; Neoplasms - complications; Neoplasms - drug therapy; Neuralgia - drug therapy; Neuralgia - etiology; Oncology; Pain Measurement; Pregabalin; Retrospective Studies; Sleep - drug effects; Sleep - physiology; Treatment Outcome; Cancer pain; Anticonvulsants; Pregabalin; Radiotherapy; Neuropathic pain
• ISSN: 1699-048X; 1699-3055
• DOI: 10.1007/s12094-011-0711-0

Background and purpose
A previous study of cancer-related neuropathic pain (NP) found that a 10-fold increase in pregabalin (PGB) use increased patients’ satisfaction with treatment. Further research of PGB vs. non-pregabalin (non-PGB) treatment was carried out to assess if the use of more specific NP-targeting drugs, such as PGB, in combined therapy, in patients with cancer-related NP, provides better health outcomes.
Patients and methods
Post hoc analysis of PGB-vs. non-PGB-treated patients in a 2-month epidemiological, prospective, multicentre study to assess NP prevalence and management in cancer pain patients visiting radiotherapy oncologic units. Patients undertook the Brief Pain Inventory (BPI), Hospital Anxiety and Depression Scale (HADS), the Medical Outcomes Sleep Scale (MOS-Sleep) and the short form (SF-12) Health Survey.
Results
A total of 273 patients with no previous PGB treatment: 162 were treated with PGB polytherapy and 111 with other treatments. At 8 weeks, satisfaction with treatment was 92.6% (PGB) vs. 78.9% (non-PGB),
p
=0.0024, and benzodiazepine use 37.8% (non-PGB) vs. 19.8% (PGB),
p
=0.0009. The decreases in BPI total pain intensity and total interference with activities and in MOS overall sleep problems index were signifi cantly larger in the PGB group.
Conclusions
The addition of more specifi c NP-targeting drugs to usual treatment, such as PGB, in NP cancer patients provides more satisfaction with treatment and better outcomes in terms of pain intensity, interference with activities and sleep than treatments without specific NP-targeting drugs. Anxiolytic profile of PGB could allow for less use of benzodiazepines.