Bhusal Santosh, Diomampo Sherilyn, Magrey Marina N
Division of Rheumatology, Metrohealth Medical Center, Cleveland OH, USA.
Case Western Reserve University School of Medicine at Metrohealth Medical Center, Cleveland OH, USA.
Drug Healthc Patient Saf. 2016 Feb 17;8:13-23. doi: 10.2147/DHPS.S95535. eCollection 2016.
Fibromyalgia is a chronic debilitating medical syndrome with limited therapeutic options. Pregabalin, an anticonvulsant and α-2-Δ subunit receptor ligand, is one of the anchor drugs approved by the US Food and Drug Administration for the treatment of fibromyalgia. The drug has shown clinically meaningful benefits across multiple symptom domains of fibromyalgia. Efficacy of pregabalin in fibromyalgia pain has been evaluated in at least five high-quality randomized trials, two long-term extension studies, a meta-analysis, a Cochrane database systematic review, and several post hoc analyses. These studies also hint towards a meaningful benefit on sleep, functioning, quality of life, and work productivity. Side effects of pregabalin, although common, are mild to moderate in intensity. They are noted early during therapy, improve or disappear with dose reduction, and are not usually life- or organ threatening. In most patients, tolerance develops to the most common side effects, dizziness, and somnolence, with time. With close clinical monitoring at initiation or dose titration, pregabalin can be effectively used in primary care setting. Pregabalin is cost saving with long-term use and its cost-effectiveness profile is comparable, if not better, to that of other drugs used in fibromyalgia. In the present era of limited therapeutic options, pregabalin undoubtedly retains its role as one of cardinal drugs used in the treatment of fibromyalgia. This review intends to discuss the clinical utility of pregabalin in the management of fibromyalgia with a focus on efficacy, safety, and cost-effectiveness.
纤维肌痛是一种慢性致残性医学综合征，治疗选择有限。普瑞巴林是一种抗惊厥药和α-2-δ亚基受体配体，是美国食品药品监督管理局批准用于治疗纤维肌痛的一线药物之一。该药在纤维肌痛的多个症状领域已显示出具有临床意义的益处。普瑞巴林治疗纤维肌痛疼痛的疗效已在至少五项高质量随机试验、两项长期延长期研究、一项荟萃分析、一项Cochrane数据库系统评价以及多项事后分析中得到评估。这些研究还提示在睡眠、功能、生活质量和工作效率方面有显著益处。普瑞巴林的副作用虽然常见，但强度为轻至中度。它们在治疗早期出现，随着剂量减少而改善或消失，通常不会危及生命或器官。在大多数患者中，随着时间推移，对最常见的副作用头晕和嗜睡会产生耐受性。在开始治疗或调整剂量时进行密切临床监测，普瑞巴林可在初级保健环境中有效使用。普瑞巴林长期使用具有成本效益，其成本效益情况与用于纤维肌痛的其他药物相当，甚至更好。在目前治疗选择有限的时代，普瑞巴林无疑仍保留其作为治疗纤维肌痛的主要药物之一的地位。本综述旨在讨论普瑞巴林在纤维肌痛管理中的临床应用，重点关注疗效、安全性和成本效益。
