PMID- 23874121
OWN - NLM
STAT- PubMed-not-MEDLINE
DCOM- 20130722
LR  - 20211021
IS  - 1178-7090 (Print)
IS  - 1178-7090 (Electronic)
IS  - 1178-7090 (Linking)
VI  - 6
DP  - 2013
TI  - Systematic review and comparison of pharmacologic therapies for neuropathic pain 
      associated with spinal cord injury.
PG  - 539-47
LID - 10.2147/JPR.S45966 [doi]
AB  - BACKGROUND: Management of neuropathic pain (NeP) associated with spinal cord 
      injury (SCI) is difficult. This report presents a systematic literature review 
      and comparison of the efficacy and safety of pharmacologic therapies for treating 
      SCI-associated NeP. METHODS: Medline, Embase, Cochrane, and Database of Abstracts 
      of Reviews of Effects were searched through December 2011 for randomized, 
      blinded, and controlled clinical trials of SCI-associated NeP meeting predefined 
      inclusion criteria. Efficacy outcomes of interest were pain reduction on the 
      11-point numeric rating scale (NRS) or 100 mm visual analog scale and proportion 
      of patients achieving >/=30% or >/=50% pain reduction. Discontinuations and adverse 
      events (AEs) were also assessed, for which Bayesian meta-analytic indirect 
      comparisons were performed. RESULTS: Of the nine studies included in the 
      analysis, samples were <100 patients, except for one pregabalin study (n = 136). 
      Standard errors for the NRS outcome were often not reported, precluding 
      quantitative comparisons across treatments. Estimated 11-point NRS pain reduction 
      relative to placebo was -1.72 for pregabalin, -1.65 for amitriptyline, -1.0 for 
      duloxetine, -1 (median) for levetiracetam, -0.27 for gabapentin, 1 (median) for 
      lamotrigine, and 2 for dronabinol. Risk ratios relative to placebo for 30% 
      improvement were 0.71 for levetiracetam and 2.56 for pregabalin, and 0.94 and 
      2.91, respectively, for 50% improvement. Meta-analytic comparisons showed 
      significantly more AEs with pregabalin and tramadol compared with placebo, and no 
      differences between placebo and any treatment for discontinuations. CONCLUSIONS: 
      Studies of SCI-associated NeP were few, small, and reported insufficient data for 
      quantitative comparisons of efficacy. However, available data suggested 
      pregabalin was associated with more favorable efficacy for all outcome measures 
      examined, and that the risks of AEs and discontinuations were found to be similar 
      among the therapies.
FAU - Snedecor, Sonya J
AU  - Snedecor SJ
AD  - Pharmerit International, Bethesda, MD, USA.
FAU - Sudharshan, Lavanya
AU  - Sudharshan L
FAU - Cappelleri, Joseph C
AU  - Cappelleri JC
FAU - Sadosky, Alesia
AU  - Sadosky A
FAU - Desai, Pooja
AU  - Desai P
FAU - Jalundhwala, Yash J
AU  - Jalundhwala YJ
FAU - Botteman, Marc
AU  - Botteman M
LA  - eng
PT  - Journal Article
DEP - 20130711
PL  - New Zealand
TA  - J Pain Res
JT  - Journal of pain research
JID - 101540514
PMC - PMC3712802
OTO - NOTNLM
OT  - indirect comparison
OT  - neuropathic pain
OT  - pharmacologic management
OT  - spinal cord injury
OT  - systematic review
EDAT- 2013/07/23 06:00
MHDA- 2013/07/23 06:01
PMCR- 2013/07/11
CRDT- 2013/07/23 06:00
PHST- 2013/07/23 06:00 [entrez]
PHST- 2013/07/23 06:00 [pubmed]
PHST- 2013/07/23 06:01 [medline]
PHST- 2013/07/11 00:00 [pmc-release]
AID - jpr-6-539 [pii]
AID - 10.2147/JPR.S45966 [doi]
PST - epublish
SO  - J Pain Res. 2013 Jul 11;6:539-47. doi: 10.2147/JPR.S45966. Print 2013.