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在西班牙初级保健环境中,对于先前治疗反应不佳的患者,普瑞巴林作为单药治疗或联合治疗对神经性疼痛的疗效。

Effectiveness of pregabalin as monotherapy or combination therapy for neuropathic pain in patients unresponsive to previous treatments in a Spanish primary care setting.

机构信息

Centro de Salud de Béjar, Salamanca, Spain.

出版信息

Clin Drug Investig. 2013 Sep;33(9):633-45. doi: 10.1007/s40261-013-0116-7.

Abstract

BACKGROUND AND OBJECTIVE

Patients from a previous study of neuropathic pain (NP) in the Spanish primary care setting still had symptoms despite treatment. Subsequently, patients were treated as prescribed by their physician and followed up for 3 months. Since pregabalin has been shown to be effective in NP, including refractory cases, the objective of this study was to assess the effectiveness of pregabalin therapy in patients with NP refractory to previous treatments.

METHODS

This was a post hoc analysis of pregabalin-naïve NP patients treated with pregabalin in a 3-month follow-up observational multicenter study to assess symptoms and satisfaction with treatment. Patients were evaluated with the Douleur Neuropathique en 4 questions (DN4), the Brief Pain Inventory (BPI) and the Treatment Satisfaction for Medication Questionnaire (SATMED-Q) overall satisfaction domain.

RESULTS

1,670 patients (mean age 58 years, 59 % women), previously untreated or treated with ≥1 drug other than pregabalin, were treated with pregabalin (37 % on monotherapy). At 3 months, pain intensity and its interference with activities decreased by half (p < 0.0001), while the number of days with no or mild pain increased by a mean of 4.5 days (p < 0.0001). Treatment satisfaction increased twofold (p < 0.0001). Patients with a shorter history of pain and those with neuralgia and peripheral nerve compression syndrome (PCS) as etiologies had the highest proportion on monotherapy and showed the greatest improvements in pain-related parameters in their respective group categories.

CONCLUSION

Treatment with pregabalin (as monotherapy or combination therapy) provides benefits in pain and treatment satisfaction in patients with NP, including refractory cases. Shorter disease progression and neuralgia and PCS etiologies are favorable factors for pregabalin treatment response.

摘要

背景与目的

在西班牙初级保健环境中进行的一项先前的神经病理性疼痛(NP)研究中,尽管进行了治疗,但患者仍存在症状。随后,根据医生的处方对患者进行了治疗,并进行了 3 个月的随访。由于普瑞巴林已被证明对 NP 包括难治性病例有效,因此本研究的目的是评估普瑞巴林治疗对先前治疗无效的 NP 患者的疗效。

方法

这是一项普瑞巴林-naive NP 患者的事后分析,这些患者在一项为期 3 个月的随访观察性多中心研究中接受普瑞巴林治疗,以评估症状和对治疗的满意度。使用 4 个问题的神经性疼痛问卷(DN4)、简明疼痛量表(BPI)和治疗满意度问卷(SATMED-Q)整体满意度领域对患者进行评估。

结果

共有 1670 名患者(平均年龄 58 岁,59%为女性),既往未接受治疗或接受过除普瑞巴林以外的≥1 种药物治疗,接受了普瑞巴林治疗(37%为单药治疗)。在 3 个月时,疼痛强度及其对活动的干扰减少了一半(p<0.0001),而无或轻度疼痛的天数平均增加了 4.5 天(p<0.0001)。治疗满意度增加了一倍(p<0.0001)。疼痛病史较短、病因是神经痛和周围神经压迫综合征(PCS)的患者采用单药治疗的比例最高,且在各自的分组类别中疼痛相关参数的改善程度最大。

结论

普瑞巴林(单药或联合治疗)治疗可改善 NP 患者的疼痛和治疗满意度,包括难治性病例。疾病进展较短、神经痛和 PCS 病因是普瑞巴林治疗反应的有利因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0251/3751224/3d5a959dc7d3/40261_2013_116_Fig1_HTML.jpg

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