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普瑞巴林治疗青少年纤维肌痛的安全性和有效性:一项随机、双盲、安慰剂对照试验及为期6个月的开放标签扩展研究。

Safety and efficacy of pregabalin in adolescents with fibromyalgia: a randomized, double-blind, placebo-controlled trial and a 6-month open-label extension study.

作者信息

Arnold Lesley M, Schikler Kenneth N, Bateman Lucinda, Khan Tahira, Pauer Lynne, Bhadra-Brown Pritha, Clair Andrew, Chew Marci L, Scavone Joseph

机构信息

University of Cincinnati College of Medicine, 260 Stetson Street, Suite 3200, Cincinnati, OH, 45219, USA.

University of Louisville School of Medicine, Kosair Children's Hospital, Louisville, KY, USA.

出版信息

Pediatr Rheumatol Online J. 2016 Jul 30;14(1):46. doi: 10.1186/s12969-016-0106-4.

Abstract

BACKGROUND

Fibromyalgia (FM) is a common pain condition characterized by widespread musculoskeletal pain and tenderness. Pregabalin is an approved treatment for adults in the United States, but there are no approved treatments for adolescents with FM.

METHODS

This was a 15-week, randomized, double-blind, placebo-controlled study and 6-month open-label safety trial of flexible-dose pregabalin (75-450 mg/day) for the treatment of adolescents (12-17 years) with FM. Primary outcome was change in mean pain score at endpoint (scored from 0-10, with 24-h recall). Secondary outcomes included global assessments and measures of pain, sleep, and FM impact.

RESULTS

A total of 107 subjects were randomized to treatment (54 pregabalin, 53 placebo) and 80 completed the study (44 pregabalin, 36 placebo). Improvement in mean pain score at endpoint with pregabalin versus placebo was not statistically significant, treatment difference (95 % CI), -0.66 (-1.51, 0.18), P = 0.121. There were significant improvements with pregabalin versus placebo in secondary outcomes of change in pain score by week (P < 0.05 for 10 of 15 weeks); change in pain score at week 15 (1-week recall), treatment difference (95 % CI), -0.87 (-1.68, -0.05), P = 0.037; and patient global impression of change, 53.1 % versus 29.5 % very much or much improved (P = 0.013). Trends toward improvement with pregabalin in other secondary outcomes measuring pain, sleep, and FM impact were not significant. Safety was consistent with the known profile of pregabalin in adults with FM.

CONCLUSION

Pregabalin did not significantly improve the mean pain score in adolescents with FM. There were significant improvements in secondary outcomes measuring pain and impression of change.

TRIAL REGISTRATIONS

NCT01020474 ; NCT01020526 .

摘要

背景

纤维肌痛(FM)是一种常见的疼痛病症,其特征为广泛的肌肉骨骼疼痛和压痛。普瑞巴林在美国是获批用于成人的治疗药物,但尚无获批用于青少年纤维肌痛患者的治疗方法。

方法

这是一项为期15周的随机、双盲、安慰剂对照研究以及为期6个月的灵活剂量普瑞巴林(75 - 450毫克/天)治疗青少年(12 - 17岁)纤维肌痛的开放标签安全性试验。主要结局是终点时平均疼痛评分的变化(采用24小时回忆法,评分范围为0 - 10分)。次要结局包括总体评估以及疼痛、睡眠和纤维肌痛影响的测量指标。

结果

共有107名受试者被随机分配接受治疗(54名接受普瑞巴林治疗,53名接受安慰剂治疗),80名完成了研究(44名接受普瑞巴林治疗,36名接受安慰剂治疗)。与安慰剂相比,普瑞巴林在终点时平均疼痛评分的改善无统计学意义,治疗差异(95%置信区间)为 -0.66(-1.51,0.18),P = 0.121。在次要结局方面,与安慰剂相比,普瑞巴林在疼痛评分每周变化(15周中有10周P < 0.05)、第15周疼痛评分变化(1周回忆法)、治疗差异(95%置信区间)为 -0.87(-1.68,-0.05),P = 0.037以及患者总体变化印象(非常明显或明显改善的比例分别为53.1%和29.5%,P = 0.013)方面有显著改善。在测量疼痛、睡眠和纤维肌痛影响的其他次要结局中,普瑞巴林的改善趋势不显著。安全性与普瑞巴林在成人纤维肌痛患者中的已知情况一致。

结论

普瑞巴林未显著改善青少年纤维肌痛患者的平均疼痛评分。在测量疼痛和变化印象的次要结局方面有显著改善。

试验注册号

NCT01020474 ;NCT01020526 。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2207/4967327/ca4df041cd47/12969_2016_106_Fig1_HTML.jpg

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