Mease Philip J, Russell I Jon, Arnold Lesley M, Florian Hana, Young James P, Martin Susan A, Sharma Uma
Seattle Rheumatology Associates, Seattle, Washington 98104, USA.
J Rheumatol. 2008 Mar;35(3):502-14. Epub 2008 Feb 15.
To evaluate the efficacy and safety of pregabalin for symptomatic relief of pain associated with fibromyalgia (FM) and for management of FM.
This multicenter, double-blind, placebo-controlled trial randomly assigned 748 patients with FM to receive placebo or pregabalin 300, 450, or 600 mg/day (dosed twice daily) for 13 weeks. The primary outcome variable for study objective 1, symptomatic relief of pain associated with FM, was comparison of endpoint mean pain scores between each pregabalin group and placebo. The outcome variable for study objective 2, management of FM, included endpoint mean pain scores, Patient Global Impression of Change (PGIC), and Fibromyalgia Impact Questionnaire (FIQ)-Total Score. Secondary outcomes included assessments of sleep, fatigue, and mood disturbance.
Patients in all pregabalin groups showed statistically significant improvement in endpoint mean pain score and in PGIC response compared with placebo. Improvements in FIQ-Total Score for the pregabalin groups were numerically but not significantly greater than those for the placebo group. Compared with placebo, all pregabalin treatment groups showed statistically significant improvement in assessments of sleep and in patients' impressions of their global improvement. Dizziness and somnolence were the most frequently reported adverse events.
Pregabalin at 300, 450, and 600 mg/day was efficacious and safe for treatment of pain associated with FM. Pregabalin monotherapy provides clinically meaningful benefit to patients with FM.
评估普瑞巴林缓解纤维肌痛(FM)相关疼痛症状及治疗FM的疗效和安全性。
这项多中心、双盲、安慰剂对照试验将748例FM患者随机分配,分别接受安慰剂或300、450或600毫克/天的普瑞巴林治疗(每日两次给药),为期13周。研究目标1(缓解FM相关疼痛症状)的主要结局变量是各普瑞巴林组与安慰剂组终点平均疼痛评分的比较。研究目标2(治疗FM)的结局变量包括终点平均疼痛评分、患者总体改善印象(PGIC)和纤维肌痛影响问卷(FIQ)总分。次要结局包括对睡眠、疲劳和情绪障碍的评估。
与安慰剂相比,所有普瑞巴林组患者的终点平均疼痛评分和PGIC反应均有统计学显著改善。普瑞巴林组FIQ总分的改善在数值上高于安慰剂组,但无显著差异。与安慰剂相比,所有普瑞巴林治疗组在睡眠评估和患者对总体改善的印象方面均有统计学显著改善。头晕和嗜睡是最常报告的不良事件。
300、450和600毫克/天的普瑞巴林治疗FM相关疼痛有效且安全。普瑞巴林单药治疗可为FM患者提供具有临床意义的益处。