PMID- 35788127
OWN - NLM
STAT- MEDLINE
DCOM- 20220706
LR  - 20230705
IS  - 2058-6124 (Electronic)
IS  - 2058-6124 (Linking)
VI  - 8
IP  - 1
DP  - 2022 Jul 4
TI  - Pharmacologic therapies of pain in patients with spinal cord injury: a systematic 
      review.
PG  - 65
LID - 10.1038/s41394-022-00529-3 [doi]
LID - 65
AB  - STUDY DESIGN: Systematic review. OBJECTIVES: This systematic review evaluates all 
      randomized clinical trials (RCTs) conducted on assessing the efficacy and safety 
      of pharmacologic therapies for the treatment of Spinal Cord Injury 
      (SCI)-associated pain. METHODS: The PubMed/Medline, EMBASE, and Cochrane library 
      online databases were searched from 1946 to May 2019 using specific search terms 
      for SCI, pain, and RCTs meeting predetermined inclusion criteria. The efficacy 
      outcome of interest was pain reduction, discontinuations, and adverse events 
      (AEs). RESULTS: Of 2746 records identified through database searching, 703 
      duplicates were deleted. 1814 were excluded, the full text of the remaining 230 
      articles was reviewed, and finally, 28 papers were selected for drafting. The 
      most studied medications were pregabalin, gabapentin, amitriptyline, and 
      ketamine. Pregabalin, gabapentin, and amitriptyline reduced VAS by more than 30%, 
      and ketamine reduced VAS by 40%. Oxcarbazepine, lamotrigine, alfentanil, 
      tramadol, and morphine added to clonidine, baclofen, and botulinum toxin type A 
      (BTA) significantly reduced pain compared with placebo. On the other hand, 
      valproate, levetiracetam, trazodone, and duloxetine did not significantly 
      alleviate SCI-associated pain compared to placebo. The risks of AEs and 
      discontinuations in anticonvulsants were the least, while it was highest in 
      analgesics. CONCLUSIONS: Studies of SCI-associated pain were few, small, 
      heterogenic in measures and values, and did not allow quantitative comparisons of 
      efficacy. However, available data suggested pregabalin and gabapentin led to a 
      more marked reduction in SCI-associated pain with fewer AEs. Additional clinical 
      studies are needed to assess the effect of established and novel management 
      options.
CI  - (c) 2022. The Author(s), under exclusive licence to International Spinal Cord 
      Society.
FAU - Asgardoon, Mohammad Hossein
AU  - Asgardoon MH
AUID- ORCID: 0000-0002-2029-1816
AD  - Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, 
      Tehran, Iran.
AD  - Iranian Student Society for Immunodeficiencies, Students' Scientific Research 
      Center, Tehran University of Medical Sciences, Tehran, Iran.
AD  - Universal Scientific Education and Research Network (USERN), Tehran, Iran.
FAU - Jazayeri, Seyed Behnam
AU  - Jazayeri SB
AUID- ORCID: 0000-0003-2860-6496
AD  - Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, 
      Tehran, Iran.
FAU - Behkar, Atefeh
AU  - Behkar A
AD  - Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, 
      Tehran, Iran.
FAU - Dabbagh Ohadi, Mohammad Amin
AU  - Dabbagh Ohadi MA
AD  - Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, 
      Tehran, Iran.
FAU - Yarmohammadi, Hossein
AU  - Yarmohammadi H
AD  - Medical Students Research Committee, Shahed University, Tehran, Iran.
FAU - Ghodsi, Zahra
AU  - Ghodsi Z
AD  - Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, 
      Tehran, Iran.
AD  - Brain and Spinal Cord Injury Research Center, Neuroscience Institute, Tehran 
      University of Medical Sciences, Tehran, Iran.
FAU - Pomerani, Tommaso Ivan
AU  - Pomerani TI
AUID- ORCID: 0000-0001-5744-7274
AD  - Department of Medicine and Surgery, School of Human Sciences, University of 
      Florence, Florence, Italy.
FAU - Mojtahedzadeh, Mojtaba
AU  - Mojtahedzadeh M
AD  - Department of Clinical Pharmacy and Critical Care Medicine, Tehran University of 
      Medical Sciences, Tehran, Iran.
FAU - Rahimi-Movaghar, Vafa
AU  - Rahimi-Movaghar V
AD  - Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, 
      Tehran, Iran. v_rahimi@sina.tums.ac.ir.
AD  - Universal Scientific Education and Research Network (USERN), Tehran, Iran. 
      v_rahimi@sina.tums.ac.ir.
AD  - Brain and Spinal Cord Injury Research Center, Neuroscience Institute, Tehran 
      University of Medical Sciences, Tehran, Iran. v_rahimi@sina.tums.ac.ir.
AD  - Department of Neurosurgery, Shariati Hospital, Tehran University of Medical 
      Sciences, Tehran, Iran. v_rahimi@sina.tums.ac.ir.
AD  - Institute of Biochemistry and Biophysics, University of Tehran, Tehran, Iran. 
      v_rahimi@sina.tums.ac.ir.
AD  - Visiting Professor, Spine Program, University of Toronto, Toronto, ON, Canada. 
      v_rahimi@sina.tums.ac.ir.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PT  - Systematic Review
DEP - 20220704
PL  - England
TA  - Spinal Cord Ser Cases
JT  - Spinal cord series and cases
JID - 101680856
RN  - 0 (Anticonvulsants)
RN  - 1806D8D52K (Amitriptyline)
RN  - 55JG375S6M (Pregabalin)
RN  - 690G0D6V8H (Ketamine)
RN  - 6CW7F3G59X (Gabapentin)
SB  - IM
MH  - Amitriptyline/therapeutic use
MH  - Anticonvulsants
MH  - Gabapentin
MH  - Humans
MH  - *Ketamine
MH  - Pain/drug therapy/etiology
MH  - Pregabalin/therapeutic use
MH  - *Spinal Cord Injuries/complications
PMC - PMC9253022
COIS- The authors declare no competing interests.
EDAT- 2022/07/06 06:00
MHDA- 2022/07/07 06:00
PMCR- 2023/07/04
CRDT- 2022/07/05 18:07
PHST- 2022/02/19 00:00 [received]
PHST- 2022/06/09 00:00 [accepted]
PHST- 2022/06/07 00:00 [revised]
PHST- 2022/07/05 18:07 [entrez]
PHST- 2022/07/06 06:00 [pubmed]
PHST- 2022/07/07 06:00 [medline]
PHST- 2023/07/04 00:00 [pmc-release]
AID - 10.1038/s41394-022-00529-3 [pii]
AID - 529 [pii]
AID - 10.1038/s41394-022-00529-3 [doi]
PST - epublish
SO  - Spinal Cord Ser Cases. 2022 Jul 4;8(1):65. doi: 10.1038/s41394-022-00529-3.