PMID- 19682321
OWN - NLM
STAT- MEDLINE
DCOM- 20091124
LR  - 20161125
IS  - 1533-2500 (Electronic)
IS  - 1530-7085 (Linking)
VI  - 9
IP  - 5
DP  - 2009 Sep-Oct
TI  - Intrathecal ziconotide for neuropathic pain: a review.
PG  - 327-37
LID - 10.1111/j.1533-2500.2009.00303.x [doi]
AB  - Neuropathic pain is a considerable burden that affects activities of daily 
      living. The management of neuropathic pain can be challenging because of multiple 
      etiologies and complex manifestations. Ziconotide is a nonopioid intrathecal (IT) 
      analgesic option for patients with neuropathic pain refractory to conventional 
      treatments. The objective of this article is to review the published literature 
      on ziconotide for the treatment of neuropathic pain. Relevant publications were 
      identified through searches of all years of 6 databases, which included PubMed, 
      EMBASE, and CINAHL. Search terms used were ziconotide, SNX-111, MVIIA, Prialt, 
      and neuropathic pain. Publications were included if ziconotide was intrathecally 
      administered (either alone or in combination with other IT agents) to treat 
      neuropathic pain of any etiology and if pain assessment was an outcome measure. 
      Data extracted included study design, IT drug doses, pain outcome measures, and 
      adverse events (AEs). Twenty-eight articles met the inclusion criteria: 5 were 
      preclinical studies and 23 were clinical studies. In the preclinical studies, 
      ziconotide demonstrated antiallodynic effects on neuropathic pain. Data from 
      double-blind, placebo-controlled (DBPC) trials indicated that patients with 
      neuropathic pain reported a mean percent improvement in pain score with 
      ziconotide monotherapy that ranged from 15.7% to 31.6%. A low starting dose and 
      slow titration of ziconotide resulted in an improved safety profile in the 
      aforementioned trials. Common AEs associated with ziconotide include nausea 
      and/or vomiting, dizziness, confusion, urinary retention, and somnolence. 
      Evidence from DBPC trials, open-label studies, case series, and case studies 
      suggests that ziconotide, as either monotherapy or in combination with other IT 
      drugs, is a potential therapeutic option for patients with refractory neuropathic 
      pain. Additional studies are needed to establish the long-term efficacy and 
      safety of ziconotide for neuropathic pain.
FAU - Rauck, Richard L
AU  - Rauck RL
AD  - Wake Forest University Health Sciences, Winston-Salem, North Carolina 27103, USA. 
      rrauck@ccrpain.com
FAU - Wallace, Mark S
AU  - Wallace MS
FAU - Burton, Allen W
AU  - Burton AW
FAU - Kapural, Leonardo
AU  - Kapural L
FAU - North, James M
AU  - North JM
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PT  - Review
DEP - 20090803
PL  - United States
TA  - Pain Pract
JT  - Pain practice : the official journal of World Institute of Pain
JID - 101130835
RN  - 0 (Analgesics, Non-Narcotic)
RN  - 0 (omega-Conotoxins)
RN  - 7I64C51O16 (ziconotide)
SB  - IM
MH  - Analgesics, Non-Narcotic/*therapeutic use
MH  - Clinical Trials as Topic
MH  - Female
MH  - Humans
MH  - Injections, Spinal/methods
MH  - Male
MH  - Nervous System Diseases/complications/*drug therapy
MH  - Pain/*drug therapy/etiology
MH  - Pain Measurement
MH  - omega-Conotoxins/*therapeutic use
RF  - 62
EDAT- 2009/08/18 09:00
MHDA- 2009/12/16 06:00
CRDT- 2009/08/18 09:00
PHST- 2009/08/18 09:00 [entrez]
PHST- 2009/08/18 09:00 [pubmed]
PHST- 2009/12/16 06:00 [medline]
AID - PPR303 [pii]
AID - 10.1111/j.1533-2500.2009.00303.x [doi]
PST - ppublish
SO  - Pain Pract. 2009 Sep-Oct;9(5):327-37. doi: 10.1111/j.1533-2500.2009.00303.x. Epub 
      2009 Aug 3.