Article

OBJECTIVE: To examine the effectiveness of gabapentin and pregabalin in
diminishing neuropathic pain and other secondary conditions in individuals with
spinal cord injury (SCI). DATA SOURCES: A systematic search was conducted using
multiple databases for relevant articles published from 1980 to June 2013. STUDY
SELECTION: Controlled and uncontrolled trials involving gabapentin and pregabalin
for treatment of neuropathic pain, with >/=3 subjects and >/=50% of study
population with SCI, were included. DATA EXTRACTION: Two independent reviewers
selected studies based on inclusion criteria and then extracted data. Pooled
analysis using Cohen's d to calculate standardized mean difference (SMD), SE, and
95% confidence interval (CI) for primary (pain) and secondary outcomes (anxiety,
depression, sleep interference) was conducted. DATA SYNTHESIS: Eight studies met
inclusion criteria. There was a significant reduction in the intensity of
neuropathic pain at <3 months (SMD=.96+/-.11; 95% CI, .74-1.19; P<.001) and
between 3 and 6 months (SMD=2.80+/-.18; 95% CI, 2.44-3.16; P<.001). A subanalysis
found a significant decrease in pain with gabapentin (SMD=1.20+/-.16; 95% CI,
.88-1.52; P<.001) and with pregabalin (SMD=1.71+/-.13; 95% CI, 1.458-1.965;
P<.001). A significant reduction in other SCI secondary conditions, including
sleep interference (SMD=1.46+/-.12; 95% CI, 1.22-1.71; P<.001), anxiety
(SMD=1.05+/-.12; 95% CI, .81-1.29; P<.001), and depression (SMD=1.22+/-.13; 95%
CI, .967-1.481; P<.001) symptoms, was shown. A significantly higher risk of
dizziness (risk ratio [RR]=2.02, P=.02), edema (RR=6.140, P=.04), and somnolence
(RR=1.75, P=.01) was observed. CONCLUSIONS: Gabapentin and pregabalin appear
useful for treating pain and other secondary conditions after SCI. Effectiveness
comparative to other analgesics has not been studied. Patients need to be
monitored closely for side effects.
CI - Copyright (c) 2014 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.
- Douleur neuropathique

Langue : ANGLAIS