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普瑞巴林缓解疼痛性糖尿病周围神经病变:一项随机、安慰剂对照试验

Relief of painful diabetic peripheral neuropathy with pregabalin: a randomized, placebo-controlled trial.

作者信息

Richter Ralph W, Portenoy Russell, Sharma Uma, Lamoreaux Linda, Bockbrader Howard, Knapp Lloyd E

机构信息

Neurology Department, St John Medical Center, Tulsa, Oklahoma, USA.

出版信息

J Pain. 2005 Apr;6(4):253-60. doi: 10.1016/j.jpain.2004.12.007.

Abstract

UNLABELLED

This was a 6-week, randomized, double-blind, multicenter study evaluating the efficacy of pregabalin in the treatment of painful diabetic neuropathy. Two hundred forty-six men and women with painful diabetic neuropathy received pregabalin (150 or 600 mg/day by mouth) or placebo. The primary efficacy variable was mean pain score at the end of treatment. Efficacy results indicate that pregabalin 600 mg/day significantly decreased mean pain score to 4.3 (vs 5.6 for placebo, P = .0002) and increased the proportion of patients who had a > or =50% decrease from baseline pain (39% vs 15% for placebo, P = .002). Pregabalin also significantly reduced sleep interference, past week and present pain intensity, sensory and affective pain scores, and bodily pain and decreased by > or =50% the number of patients describing their pain as gnawing, sickening, fearful, and punishing-cruel. More patients receiving pregabalin 600 mg/day than placebo showed improvement, as rated on the Clinical and Patient Global Impression of Change scales, 73% vs 45% and 85% vs 47%, respectively. Pregabalin 150 mg/day was essentially no different from placebo. Dizziness was the most common side effect. These study results show pregabalin 600 mg/day to be safe and effective in reducing the pain and other associated symptoms of painful diabetic neuropathy.

PERSPECTIVE

Painful diabetic peripheral neuropathy is a challenging neuropathic pain syndrome. This randomized controlled trial demonstrates that pregabalin, a new drug that interacts with the alpha2-delta protein subunit of the voltage-gated calcium channel, is an efficacious and safe treatment for the pain of this condition.

摘要

未标注

这是一项为期6周的随机、双盲、多中心研究,旨在评估普瑞巴林治疗痛性糖尿病神经病变的疗效。246名患有痛性糖尿病神经病变的男性和女性接受了普瑞巴林(口服150或600毫克/天)或安慰剂治疗。主要疗效变量是治疗结束时的平均疼痛评分。疗效结果表明,普瑞巴林600毫克/天可显著降低平均疼痛评分至4.3(安慰剂组为5.6,P = 0.0002),并使疼痛较基线水平降低≥50%的患者比例增加(安慰剂组为15%,普瑞巴林组为39%,P = 0.002)。普瑞巴林还显著减少了睡眠干扰、过去一周和当前的疼痛强度、感觉性和情感性疼痛评分以及身体疼痛,并使将疼痛描述为啃咬样、令人作呕、恐惧和折磨性-残忍的患者数量减少≥50%。在临床和患者总体变化印象量表上,接受普瑞巴林600毫克/天治疗的患者比接受安慰剂治疗的患者改善更多,分别为73%对45%和85%对47%。普瑞巴林150毫克/天与安慰剂基本无差异。头晕是最常见的副作用。这些研究结果表明,普瑞巴林600毫克/天在减轻痛性糖尿病神经病变的疼痛及其他相关症状方面安全有效。

观点

痛性糖尿病周围神经病变是一种具有挑战性的神经病理性疼痛综合征。这项随机对照试验表明,普瑞巴林作为一种与电压门控钙通道的α2-δ蛋白亚基相互作用的新药,是治疗这种疾病疼痛的一种有效且安全的疗法。

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