Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba 260-8670, Japan.
Yonsei Med J. 2013 Sep;54(5):1253-8. doi: 10.3349/ymj.2013.54.5.1253.
Osteoarthritic pain is largely considered to be inflammatory pain. Sensory nerve fibers innervating the knee have been shown to be significantly damaged in rat models of knee osteoarthritis (OA) in which the subchondral bone junction is destroyed, and this induces neuropathic pain (NP). Pregabalin was developed as a pain killer for NP; however, there are no reports on pregabalin use in OA patients. The purpose of this study was to investigate the efficacy of pregabalin for pain in OA patients.
Eighty-nine knee OA patients were evaluated in this randomized prospective study. Patients were divided into meloxicam, pregabalin, and meloxicam+pregabalin groups. Pain scores were evaluated before and 4 weeks after drug application using a visual analogue scale (VAS), and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Pain scales among groups were compared using a Kruskal-Wallis test.
Before drug application, there was no significant difference in VAS and WOMAC scores among the three groups (p>0.05). Significant pain relief was seen in the meloxicam+pregabalin group in VAS at 1, 2, and 4 weeks, and WOMAC score at 4 weeks, compared with the other groups (p<0.05). No significant pain relief was seen in the meloxicam only group in VAS during 4 weeks and WOMAC score at 4 weeks compared with the pregabalin only group (p>0.05).
Meloxicam+pregabalin was effective for pain in OA patients. This finding suggests that OA pain is a combination of inflammatory and NP.
骨关节炎疼痛在很大程度上被认为是炎症性疼痛。已经表明，在膝关节骨关节炎（OA）模型中，支配膝关节的感觉神经纤维明显受损，其中软骨下骨交界处被破坏，这会引起神经性疼痛（NP）。普瑞巴林是为治疗 NP 而开发的止痛药；然而，目前尚无关于 OA 患者使用普瑞巴林的报道。本研究旨在探讨普瑞巴林治疗 OA 患者疼痛的疗效。
在这项随机前瞻性研究中，评估了 89 例膝关节 OA 患者。患者分为美洛昔康、普瑞巴林和美洛昔康+普瑞巴林组。使用视觉模拟评分（VAS）和西安大略和麦克马斯特大学骨关节炎指数（WOMAC）在药物应用前和 4 周后评估疼痛评分。使用 Kruskal-Wallis 检验比较组间疼痛评分。
在药物应用前，三组之间 VAS 和 WOMAC 评分无显著差异（p>0.05）。与其他组相比，美洛昔康+普瑞巴林组在 1、2 和 4 周的 VAS 和 4 周的 WOMAC 评分中均有显著的疼痛缓解（p<0.05）。与普瑞巴林组相比，仅用美洛昔康组在 4 周的 VAS 和 4 周的 WOMAC 评分中均无显著的疼痛缓解（p>0.05）。
美洛昔康+普瑞巴林对 OA 患者的疼痛有效。这一发现表明，OA 疼痛是炎症性和 NP 的组合。
