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Reviews on Recent Clinical Trials

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ISSN (Print): 1574-8871
ISSN (Online): 1876-1038

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Research Article

The Clinical Difference between Gabapentin and Pregabalin: Data from a Pilot Comparative Trial

Author(s): Omar Gammoh*, Ahmed Al-Smadi, Mohammad Q. Shawagfeh, Thani Abadi, Jawad Kasawneh, Sukaina Malkawi and Sima Zein

Volume 16, Issue 3, 2021

Published on: 01 February, 2021

Page: [279 - 287] Pages: 9

DOI: 10.2174/1574887116666210201110507

Price: $65

Abstract

Background: Similar anticonvulsants, such as gabapentin and pregabalin are recommended in neuropathic pain management, however little is known about their clinical differences in cases of low back pain. This paper aims to highlight some of the possible clinical differences between gabapentin and pregabalin in low back pain.

Methods: Patients with moderate to severe low back pain were recruited. Eligible patients were randomised to receive either pregabalin (300 mg/day)or gabapentin (800 mg/day) for six weeks.

The primary outcome measure was pain intensity according to the Visual Analogue Score (VAS) at baseline and at six weeks. The secondary outcome measures were: anxiety, insomnia, fatigue and the self-rated (GCI), measured at baseline, second, fourth, and the sixth week.

Results: A total of 64 patients, pregabalin group (n=28), gabapentin group (n=36) completed the study. While pregabalin group showed a significantly lower pain score (p=0.039). The gabapentin group showed significant improvement in anxiety (p=0.001), insomnia (p=0.001), general fatigue (p=0.009), physical fatigue (p=0.001), reduce activity (p=0.001), and mental fatigue (p=0.014) higher than that of pregabalin. No difference in (GCI) was seen at six weeks.

Conclusion: This is the first trial aimed at comparing gabapentin with pregabalin in NLBP. Although the results are preliminary, in our pilot study pregabalin was found to be superior in pain reduction, gabapentin demonstrated better effect on anxiety, insomnia and fatigue symptoms. The results are preliminary and studies with a larger sample size are still required.

Keywords: Gabapentin, pregabalin, pilot comparative trial, low back pain, anticonvulsants, neuropathic pain management, global clinical impression (GCI).

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[1]
Carey TS, Garrett J, Jackman A, McLaughlin C, Fryer J, Smucker DR. The outcomes and costs of care for acute low back pain among patients seen by primary care practitioners, chiropractors, and orthopedic surgeons. The North Carolina Back Pain Project. N Engl J Med 1995; 333(14): 913-7.
[http://dx.doi.org/10.1056/NEJM199510053331406] [PMID: 7666878]
[2]
Djavid GE, Mehrdad R, Ghasemi M, Hasan-Zadeh H, Sotoodeh- Manesh A, Pouryaghoub G. In chronic low back pain, low level laser therapy combined with exercise is more beneficial than exercise alone in the long term: A randomised trial. Aust J Physiother 2007; 53(3): 155-60.
[http://dx.doi.org/10.1016/S0004-9514(07)70022-3] [PMID: 17725472]
[3]
Kaki AM, El-Yaski AZ, Youseif E. Identifying neuropathic pain among patients with chronic low-back pain: use of the Leeds Assessment of Neuropathic Symptoms and Signs pain scale. Reg Anesth Pain Med 2005; 30(5): 422-8.
[http://dx.doi.org/10.1097/00115550-200509000-00002] [PMID: 16135345]
[4]
Freynhagen R, Rolke R, Baron R, et al. Pseudoradicular and radicular low-back pain- a disease continuum rather than different entities? Answers from quantitative sensory testing. Pain 2008; 135(1-2): 65-74.
[http://dx.doi.org/10.1016/j.pain.2007.05.004] [PMID: 17570589]
[5]
Beith ID, Kemp A, Kenyon J, Prout M, Chestnut TJ. Identifying neuropathic back and leg pain: a cross-sectional study. Pain 2011; 152(7): 1511-6.
[http://dx.doi.org/10.1016/j.pain.2011.02.033] [PMID: 21396774]
[6]
Fishbain DA, Cutler R, Rosomoff HL, Rosomoff RS. Evidence-based data from animal and human experimental studies on pain relief with antidepressants: A structured review. Pain Med 2000; 1(4): 310-6.
[http://dx.doi.org/10.1046/j.1526-4637.2000.00042.x] [PMID: 15101877]
[7]
Kovacs FM, Abraira V, Zamora J, et al. Kovacs-Atención Primaria Group. Correlation between pain, disability, and quality of life in patients with common low back pain. Spine 2004; 29(2): 206-10.
[http://dx.doi.org/10.1097/01.BRS.0000107235.47465.08] [PMID: 14722416]
[8]
Mehta S, McIntyre A, Dijkers M, Loh E, Teasell RW. Gabapentinoids are effective in decreasing neuropathic pain and other secondary outcomes after spinal cord injury: A meta-analysis. Arch Phys Med Rehabil 2014; 95(11): 2180-6.
[http://dx.doi.org/10.1016/j.apmr.2014.06.010] [PMID: 24992021]
[9]
Bockbrader HN, Wesche D, Miller R, Chapel S, Janiczek N, Burger P. A comparison of the pharmacokinetics and pharmacodynamics of pregabalin and gabapentin. Clin Pharmacokinet 2010; 49(10): 661-9.
[http://dx.doi.org/10.2165/11536200-000000000-00000] [PMID: 20818832]
[10]
Hamilton M. The assessment of anxiety states by rating. Br J Med Psychol 1959; 32(1): 50-5.
[http://dx.doi.org/10.1111/j.2044-8341.1959.tb00467.x] [PMID: 13638508]
[11]
Library FL-AE, Cairo undefined, Egypt undefined, 1994 undefined Hamilton Anxiety Rating Scale (HAM-A). 1994.
[12]
Gammoh OS, Al-Smadi A, Al-Awaida W, Badr MM, Qinna NA. Increased Salivary Nitric Oxide and G6PD Activity in Refugees with Anxiety and Stress. Stress Health 2016; 32(4): 435-40.
[http://dx.doi.org/10.1002/smi.2666] [PMID: 26680108]
[13]
Morin C. Insomnia: Psychological assessment and management. 1993.
[14]
Suleiman KH, Yates BC. Translating the insomnia severity index into Arabic. J Nurs Scholarsh 2011; 43(1): 49-53.
[http://dx.doi.org/10.1111/j.1547-5069.2010.01374.x] [PMID: 21342424]
[15]
Smets EMA, Garssen B, Bonke B, De Haes JCJM. The Multidimensional Fatigue Inventory (MFI) psychometric qualities of an instrument to assess fatigue. J Psychosom Res 1995; 39(3): 315-25.
[http://dx.doi.org/10.1016/0022-3999(94)00125-O] [PMID: 7636775]
[16]
Guy W. ECDEU assessment manual for psychopharmacology Rev US Dept of Health Education and Welfare Public Health Service Alcohol Drug Abuse and Mental Health Administration National Institute of Mental Health Psychopharmacology Research Branch. 1976.
[17]
Kamble S, Motlekar S. LD-TK journal, 2017 undefined Low doses of amitriptyline, pregabalin, and gabapentin are preferred for management of neuropathic pain in India: Is there a need for revisiting dosing. 2017.ncbi.nlm.nih.gov
[18]
Clarke H, Kirkham KR, Orser BA, et al. Gabapentin reduces preoperative anxiety and pain catastrophizing in highly anxious patients prior to major surgery: a blinded randomized placebo-controlled trial. Can J Anaesth 2013; 60(5): 432-43.
[http://dx.doi.org/10.1007/s12630-013-9890-1] [PMID: 23377862]
[19]
Berlin R, Butler P. For MP-T primary care companion, 2015 undefined Gabapentin therapy in psychiatric disorders: a systematic review 2015.ncbi.nlm.nih.gov
[20]
Calandre EP, Rico-Villademoros F, Slim M. Alpha2delta ligands, gabapentin, pregabalin and mirogabalin: A review of their clinical pharmacology and therapeutic use. Expert Rev Neurother 2016; 16(11): 1263-77.
[http://dx.doi.org/10.1080/14737175.2016.1202764] [PMID: 27345098]

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