PMID- 23464813
OWN - NLM
STAT- MEDLINE
DCOM- 20140908
LR  - 20151119
IS  - 1533-2500 (Electronic)
IS  - 1530-7085 (Linking)
VI  - 14
IP  - 1
DP  - 2014 Jan
TI  - Pregabalin vs. opioids for the treatment of neuropathic cancer pain: a 
      prospective, head-to-head, randomized, open-label study.
PG  - 32-42
LID - 10.1111/papr.12045 [doi]
AB  - OBJECTIVES: Neuropathic cancer pain (NCP) is a common manifestation of cancer 
      and/or its treatment. Treatment following the WHO analgesic ladder provides 
      relief for the majority of cancer pain patients; however, concern remains that 
      opioids may be less efficacious for neuropathic pain (NP) compared with 
      nociceptive pain, often necessitating the use of higher doses. Adjuvants, such as 
      pregabalin, have shown to be efficacious for the treatment of NP, although data 
      come mostly from noncancer studies. The comparative efficacy and safety of 
      opioids versus adjuvants has not been studied for NCP. The aim of this study was 
      to directly compare pregabalin versus a strong opioid for the treatment of NCP. 
      METHODS: A total of 120 patients, diagnosed with "definite" NCP, were randomized 
      into two groups and received increasing doses of either oral pregabalin or 
      transdermal fentanyl for 28 days. VAS score, patient satisfaction, need for 
      opioid rescue, and adverse events (AEs) were recorded. RESULTS: In the pregabalin 
      group, a significantly higher proportion of patients achieved at least 30% 
      reduction in VAS compared with the fentanyl group (73.3%, 95% CI: 60.3%-83.93 vs. 
      36.7%, 95% CI: 24.5%-50.1%, P < 0.0001, respectively), while the percentage mean 
      change from baseline was also significantly different [46% (95% CI: 39.5%-52.8%) 
      for pregabalin and 22% (95% CI: 14.9%-29.5%) for fentanyl (P < 0.0001)]. 
      Patient-reported satisfaction was more frequent with pregabalin, while AEs and 
      treatment discontinuations were more frequent in the fentanyl group. DISCUSSION: 
      Prompt use of a neuropathic pain-specific adjuvant, such as pregabalin, in NCP 
      may lead to better control of the neuropathic component, with opioid-sparing 
      effects.
CI  - (c) 2013 The Authors Pain Practice (c) 2013 World Institute of Pain.
FAU - Raptis, Efklidis
AU  - Raptis E
AD  - 1st Anaesthesiology Department, Pain Relief & Palliative Care Center, Aretaieion 
      Hospital, Medical School, University of Athens, Athens, Greece.
FAU - Vadalouca, Athina
AU  - Vadalouca A
FAU - Stavropoulou, Evmorfia
AU  - Stavropoulou E
FAU - Argyra, Eriphili
AU  - Argyra E
FAU - Melemeni, Aikaterini
AU  - Melemeni A
FAU - Siafaka, Ioanna
AU  - Siafaka I
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Randomized Controlled Trial
PT  - Research Support, Non-U.S. Gov't
DEP - 20130306
PL  - United States
TA  - Pain Pract
JT  - Pain practice : the official journal of World Institute of Pain
JID - 101130835
RN  - 0 (Analgesics, Opioid)
RN  - 55JG375S6M (Pregabalin)
RN  - 56-12-2 (gamma-Aminobutyric Acid)
SB  - IM
MH  - Aged
MH  - Analgesics, Opioid/pharmacology/*therapeutic use
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Neoplasms/*drug therapy/epidemiology
MH  - Neuralgia/*drug therapy/epidemiology
MH  - Pain Measurement/drug effects/*methods
MH  - Pregabalin
MH  - Prospective Studies
MH  - Treatment Outcome
MH  - gamma-Aminobutyric Acid/*analogs & derivatives/pharmacology/therapeutic use
OTO - NOTNLM
OT  - adjuvants
OT  - cancer pain
OT  - fentanyl
OT  - neuropathic
OT  - neuropathic cancer pain
OT  - opioids
OT  - pregabalin
EDAT- 2013/03/08 06:00
MHDA- 2014/09/10 06:00
CRDT- 2013/03/08 06:00
PHST- 2012/12/13 00:00 [received]
PHST- 2013/01/27 00:00 [accepted]
PHST- 2013/03/08 06:00 [entrez]
PHST- 2013/03/08 06:00 [pubmed]
PHST- 2014/09/10 06:00 [medline]
AID - 10.1111/papr.12045 [doi]
PST - ppublish
SO  - Pain Pract. 2014 Jan;14(1):32-42. doi: 10.1111/papr.12045. Epub 2013 Mar 6.