Dent Neurologic Institute, Amherst, New York, USA.
J Pain. 2013 Jun;14(6):590-603. doi: 10.1016/j.jpain.2013.01.768. Epub 2013 Apr 18.
UNLABELLED: Gabapentin enacarbil (GEn) is an actively transported prodrug of gabapentin that provides sustained, dose-proportional exposure to gabapentin. This randomized, double-blind, parallel-group, placebo-controlled study evaluated the safety and efficacy of 3 different maintenance doses of oral GEn in subjects with postherpetic neuralgia. Adults with a 24-hour average pain intensity score of ≥4.0 received GEn 1,200 mg, 2,400 mg, 3,600 mg, or placebo for 14 weeks (including a 1-week up-titration, 12-week maintenance, and 1-week taper). The primary endpoint was change from baseline to end of maintenance treatment in mean 24-hour average pain intensity score. The intent-to-treat population consisted of 371 subjects (GEn 1,200 mg = 107, 2,400 mg = 82, 3,600 mg = 87, placebo = 95). With regard to the primary endpoint, all 3 GEn treatment groups demonstrated a statistically significant difference relative to placebo. The adjusted mean change from baseline for the treatment groups ranged from -2.36 to -2.72 versus -1.66 for the placebo group. Exposure-response modeling suggested an ED50 around 1,200 mg/day, which was consistent with historical findings reported for gabapentin. The most commonly reported adverse events were dizziness and somnolence. All studied doses of GEn significantly improved pain associated with postherpetic neuralgia as compared to placebo and were well tolerated. PERSPECTIVE: GEn provides clinically important pain relief with doses from 1,200 mg to 3,600 mg and is generally well tolerated and efficacious. As an actively transported prodrug of gabapentin, it provides dose-proportional and extended exposure to gabapentin.
未加标签:加巴喷丁乙酰氨基丙醇(GEn)是加巴喷丁的主动转运前体药物,可提供持续、剂量比例的加巴喷丁暴露。这项随机、双盲、平行组、安慰剂对照研究评估了 3 种不同维持剂量口服 GEn 在带状疱疹后神经痛患者中的安全性和疗效。24 小时平均疼痛强度评分≥4.0 的成年人接受 GEn 1200mg、2400mg、3600mg 或安慰剂治疗 14 周(包括 1 周滴定期、12 周维持期和 1 周减量期)。主要终点是从基线到维持治疗结束时平均 24 小时平均疼痛强度评分的变化。意向治疗人群包括 371 名受试者(GEn 1200mg=107,2400mg=82,3600mg=87,安慰剂=95)。关于主要终点,所有 3 种 GEn 治疗组与安慰剂相比均显示出统计学显著差异。治疗组从基线的平均变化范围为-2.36 至-2.72,安慰剂组为-1.66。暴露-反应模型表明 ED50 约为 1200mg/天,与先前报道的加巴喷丁结果一致。最常见的不良反应是头晕和嗜睡。与安慰剂相比,所有研究剂量的 GEn 均显著改善了带状疱疹后神经痛相关的疼痛,且耐受性良好。 观点:与安慰剂相比,GEn 提供了 1200mg 至 3600mg 的临床重要疼痛缓解,并且通常具有良好的耐受性和疗效。作为加巴喷丁的主动转运前体药物,它提供了剂量比例和延长的加巴喷丁暴露。
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