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普瑞巴林治疗糖尿病周围神经病变相关神经性疼痛的疗效和安全性:一项为期 14 周、随机、双盲、安慰剂对照试验。

Efficacy and safety of pregabalin for treating neuropathic pain associated with diabetic peripheral neuropathy: a 14 week, randomized, double-blind, placebo-controlled trial.

机构信息

Division of Diabetes and Metabolism, Department of Internal Medicine, Iwate Medical University School of Medicine, Morioka, Iwate, Japan.

出版信息

Diabet Med. 2011 Jan;28(1):109-16. doi: 10.1111/j.1464-5491.2010.03152.x.

DOI:10.1111/j.1464-5491.2010.03152.x
PMID:21166852
Abstract

AIMS

To evaluate the efficacy, safety and pharmacokinetics of pregabalin in treating neuropathic pain associated with diabetic peripheral neuropathy in Japanese patients.

METHODS

A randomized, double-blind, placebo-controlled, multicentre 14 week clinical trial was conducted. Japanese patients with diabetic peripheral neuropathy (n = 317) were randomized to receive placebo or pregabalin at 300 or 600 mg/day. The primary efficacy measure was a change of mean pain score from baseline to end-point from patients' daily pain diaries.

RESULTS

Significant reductions in pain were observed in patients treated with pregabalin at 300 and 600 mg/day vs. placebo (P < 0.05). Improvements in weekly pain scores were observed as early as week 1 and were sustained throughout the study period (300 and 600 mg/day difference from placebo at study end-point, -0.63 and -0.74, respectively). Pregabalin produced significant improvements in weekly sleep interference scores, the short-form McGill Pain Questionnaire, the Medical Outcomes Study-Sleep Scale, the 36-item Short-Form Health Survey scale, and the Patient and Clinical Global Impression of Change. Patient impressions of numbness, pain and paraesthesia were also significantly improved. Regarding treatment responders, 29.1 and 35.6% of patients treated with 300 and 600 mg/day, respectively, reported ≥ 50% improvement in mean pain scores (vs. 21.5% for placebo). Pregabalin was well tolerated; somnolence (26%), dizziness (24%), peripheral oedema (13%) and weight gain (11%) were the most common adverse events and generally were reported as mild to moderate.

CONCLUSIONS

Pregabalin was effective in reducing pain and improving sleep disturbances due to pain, and was well tolerated in Japanese patients with painful DPN.

摘要

目的

评估普瑞巴林治疗日本糖尿病周围神经病变相关神经性疼痛的疗效、安全性和药代动力学。

方法

进行了一项随机、双盲、安慰剂对照、多中心的 14 周临床试验。317 例日本糖尿病周围神经病变患者随机接受安慰剂或普瑞巴林 300 或 600mg/天治疗。主要疗效指标为患者每日疼痛日记自基线至终点时的平均疼痛评分变化。

结果

普瑞巴林 300 和 600mg/天组患者的疼痛均显著减轻(P<0.05)。治疗第 1 周时即观察到每周疼痛评分的改善,并在整个研究期间持续(研究终点时与安慰剂相比,300 和 600mg/天组差值分别为-0.63 和-0.74)。普瑞巴林还显著改善每周睡眠干扰评分、简明 McGill 疼痛问卷、医疗结局研究睡眠量表、36 项简短健康调查量表以及患者和临床总体印象变化。患者对麻木、疼痛和感觉异常的印象也显著改善。在治疗应答者方面,分别有 29.1%和 35.6%的 300 和 600mg/天治疗患者报告平均疼痛评分改善≥50%(安慰剂组为 21.5%)。普瑞巴林耐受性良好;最常见的不良反应为嗜睡(26%)、头晕(24%)、外周水肿(13%)和体重增加(11%),通常为轻至中度。

结论

普瑞巴林可有效减轻日本糖尿病周围神经病变疼痛患者的疼痛并改善疼痛所致睡眠障碍,且耐受良好。

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