(Neuropathic pain, NP) refers to the pain caused by injury or disease in the somatosensory pathway of the central or peripheral nervous system. After the injury or illness is cured, the pain is still sustainable, often evolving into chronic pain. NP diagnosis and treatment more difficult, often associated with anxiety, depression and sleep disorders.
Pre-existing studies have shown that pregabalin
is effective for many types of NPs and can also improve anxiety symptoms and sleep disorders in patients. An epidemiological cross-sectional study conducted in primary hospitals in Spain found that most patients with NP did not receive proper medication, and their efficacy was unsatisfactory and treatment satisfaction was poor.
The investigators also conducted three subgroup analyzes based on the patient's NP course, etiology, and baseline pain level.
The subgroup analysis of course of disease showed that the degree of pain, the degree of life impact, the number of days without / mild pain, and the improvement of treatment satisfaction were the most significant after treatment within 3 months.
The etiology subgroup analysis showed that pregabalin was effective for all etiologies of NP (p <0.0001). Of these, neuropathic pain and peripheral compression syndrome (PCS) patients achieved the most improvement in the degree of pain, the degree of life impact, and the number of days without / mild pain, whereas the efficacy in patients with neuralgia and complex regional pain syndrome (CRPS) The highest proportion of significant (62.9% and 65.6%, respectively).
The results of subgroup analysis of baseline pain degree showed that the degree of pain and life impact of the group without pain, the pain with moderate pain and the pain with severe pain decreased obviously, and the satisfaction of treatment increased obviously with no significant difference between the groups; / Mild pain days, the less severe the baseline pain, the more the number of days without pain / mild pain after treatment (p <0.0001).
The first-line treatment for NP is antiepileptic and antidepressant, while the second-line is opioid analgesics. However, NP patients currently receiving primary care still use NSAIDs (53%) and non-opioid analgesics (51% ). The study confirms that pregabalin, an antiepileptic drug, significantly reduces pain and life impact in patients with refractory NP who have not previously been treated with pregabalin, and increases the number of patients who have no / Degree of pain days. However, the study has not been able to determine the use of pregabalin monotherapy or combined with other drug treatment better.