Gabapentin for acute pain in sickle cell disease: A randomized double-blinded placebo-controlled phase II clinical trial

被引:4
作者
Puri, Latika [1 ,5 ]
Nottage, Kerri [2 ]
Hankins, Jane S. [1 ]
Wang, Winfred C. [1 ]
McGregor, Olivia [1 ]
Gossett, Jeffrey M. [3 ]
Kang, Guolian [3 ]
Anghelescu, Doralina L. [4 ]
机构
[1] St Jude Childrens Res Hosp, Dept Hematol, Memphis, TN USA
[2] Janssen Res & Dev, Raritan, NJ USA
[3] St Jude Childrens Res Hosp, Dept Biostat, Memphis, TN USA
[4] St Jude Childrens Res Hosp, Div Anesthesia, Dept Pediat Med, 262 Danny Thomas Pl,Mail Stop 130, Memphis, TN 38105 USA
[5] Loma Linda Univ, Dept Pediat, Div Pediat Hematol Oncol, Childrens Hosp, Loma Linda, CA USA
来源
EJHAEM | 2021年 / 2卷 / 03期
关键词
gabapentin; neuropathic pain; randomized controlled trial; sickle cell disease; NEUROPATHIC PAIN; PREOPERATIVE GABAPENTIN; POSTOPERATIVE PAIN; CHILDREN; MANAGEMENT; ADULTS; MICE; ADOLESCENTS; MECHANISMS; PREGABALIN;
D O I
10.1002/jha2.188
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Pain in sickle cell disease (SCD) can have a neuropathic component. This randomized phase II double-blinded placebo-controlled study evaluated the efficacy of gabapentin in reducing pain and opioid consumption (morphine-equivalent dose [MED]) during acute vaso-occlusive crisis (VOC). Of 90 patients aged 1-18 years with VOC pain, 45 were randomized to a single gabapentin dose (15 mg/kg) and 45 to placebo, in addition to standard treatment; 42 and 44 patients were evaluable in the gabapentin and placebo arms, respectively. A decrease in pain of >= 33% was reported in 68% of patients in the gabapentin arm and 60% of those in the placebo arm (one-sided p = 0.23). The median MED (mg/kg) in the gabapentin (0.12) and placebo arms (0.13) was similar (p = 0.9). However, in the subset of patients with the HbSS genotype (n = 45), the mean (SD) absolute pain score decrease by the time of discharge was significantly greater in the gabapentin arm (5.9 [3.5]) than in the placebo arm (3.6 [3.3]) (p = 0.032). Pain scores in the overall study population were not significantly reduced when gabapentin was added to standard treatment; however, gabapentin benefited individuals with the more severe genotype, HbSS, during acute VOC. Larger, prospective studies are needed to confirm these findings.
引用
收藏
页码:327 / 334
页数:8
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