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5%利多卡因贴剂治疗具有神经病理性和/或炎症特征的局限性疼痛的疗效和安全性:一项观察性、真实世界研究。

Efficacy and safety of 5% lidocaine-medicated plasters in localized pain with neuropathic and/or inflammatory characteristics: an observational, real-world study.

机构信息

Pain Therapy Regional Hub, Cosenza Hospital, Cosenza, Italy.

出版信息

Eur Rev Med Pharmacol Sci. 2017 Sep;21(18):4228-4235.

Abstract

OBJECTIVE

Based on clinical study results, 5% lidocaine-medicated plaster (5% LMP) is currently recommended for the treatment of localized peripheral neuropathic pain, such as post-herpetic neuralgia (PHN). However, its effective action, as well as the high safety, have indeed led to its use in clinical practice for pain conditions with similar pathophysiological mechanisms. In this study, the efficacy and safety of 5% LMP were investigated in patients with localized pain with neuropathic and/or inflammatory characteristics, such as PHN, post-traumatic/surgical or musculoskeletal pain.

PATIENTS AND METHODS

503 patients with localized pain treated with 5% LMP were evaluated at baseline (T0), after 30 days (T30) and after 60 days (T60). The primary endpoint was number and proportion of 30% responders at T60, whereas secondary endpoints included number and proportion of 30% responders at T30, mean pain intensity, mean extension of the painful area, dynamic mechanical allodynia and quality of sleep. Evaluations were assessed in all patients and subgroups based on different clinical entities. Concomitant treatments and adverse reactions were also recorded.

RESULTS

72% and 90% of all patients responded to 5% LMP treatment at T30 and T60, respectively. Comparable results were also obtained in subgroups such as PHN patients (72% and 68% at T30 and T60, respectively), and musculoskeletal pain (73% and 83% at T30 and T60, respectively). The mean pain intensity, as well as the extension of the painful area, significantly decreased during the study, in all patients and each subgroup. In addition, secondary endpoints significantly improved at each time-point compared with baseline, in all groups.

CONCLUSIONS

The effectiveness and safety of 5% LMP were shown in localized pain conditions such as neuropathic and, importantly, in musculoskeletal pain, a condition never investigated with this product. This field-practice study suggests that topical pain-reducing strategies such as 5% LMP could be effective in neuropathic and/or inflammatory, localized pain conditions.

摘要

目的

基于临床研究结果,目前推荐使用 5%利多卡因贴剂(5% LMP)治疗局部周围神经性疼痛,如带状疱疹后神经痛(PHN)。然而,其有效作用和高度安全性确实导致其在具有相似病理生理机制的疼痛情况下在临床实践中使用。在这项研究中,研究了 5% LMP 在具有神经病理性和/或炎症性特征的局部疼痛患者中的疗效和安全性,如 PHN、创伤后/手术后或肌肉骨骼疼痛。

患者和方法

503 名局部疼痛患者使用 5% LMP 治疗,在基线(T0)、第 30 天(T30)和第 60 天(T60)进行评估。主要终点是 T60 时 30%应答者的数量和比例,次要终点包括 T30 时 30%应答者的数量和比例、平均疼痛强度、疼痛区域的平均扩展、动态机械性感觉过敏和睡眠质量。根据不同的临床实体,对所有患者和亚组进行了评估。还记录了伴随治疗和不良反应。

结果

所有患者在 T30 和 T60 时分别有 72%和 90%对 5% LMP 治疗有反应。在 PHN 患者(T30 和 T60 时分别为 72%和 68%)和肌肉骨骼疼痛患者(T30 和 T60 时分别为 73%和 83%)等亚组中也获得了类似的结果。在所有患者和每个亚组中,研究期间平均疼痛强度以及疼痛区域的扩展均显著降低。此外,与基线相比,所有组在每个时间点的次要终点均显著改善。

结论

5% LMP 在局部疼痛情况(如神经病理性疼痛,重要的是肌肉骨骼疼痛)中的有效性和安全性已得到证实,而这种产品从未在这种情况下进行过研究。这项实践研究表明,局部止痛策略(如 5% LMP)可能对神经病理性和/或炎症性、局部疼痛情况有效。

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