Department of Outpatient Oncology Unit, University Hospital, Kyoto Prefectural University of Medicine, Kyoto, Japan; Department of Education and Research Center for Clinical Pharmacy, Osaka University of Pharmaceutical Sciences, Osaka; Department of Endocrine and Breast Surgery, Graduate School of Medical Science, Kyoto, Japan;, Email:
Departments of Pain Management & Palliative Care Medicine, Graduate School of Medical Science, Kyoto, Japan.
Pharmazie. 2020 Nov 1;75(11):602-605. doi: 10.1691/ph.2020.0741.
Mirogabalin is a novel, preferentially selective α2δ-1 ligand to treat neuropathic pain. However, this agent is not always effective for patients with neuropathic pain. We therefore attempted to identify factors that could predict the efficacy of mirogabalin. The study comprised 133 patients given mirogabalin for alleviation of neuropathic pain between April and November 2019 at our hospital. Variables were extracted from medical records for regression analysis of factors associated to alleviation of neuropathic pain. We evaluated the effect of mirogabalin at two weeks after administration. Groups were categorized according to degree of improvement: poor, effective, or very effective. Multivariate ordered logistic regression analysis was conducted to identify predictors for the usefulness of mirogabalin. Threshold measures were analysed using receiver operating characteristic (ROC) curves. Maintenance dose [odds ratio (OR) = 0.90; 95% confidence interval (CI) = 0.84-0.98; P = 0.01], concomitant use of opioids (OR = 0.26, 95% CI = 0.08-0.83; P = 0.023) and Neurotropin (NTP) (OR = 4.78, 95% CI =1.04-21.93; P = 0.044) were factors significantly correlated to the effect of mirogabalin. ROC curve analysis of the effective group indicated a threshold maintenance dose of≤ 20 mg/day (area under the curve [AUC] = 0.53). In conclusion, maintenance dose (≤ 20 mg), concomitant use of opioids and NTP were identified as predictors for the utility of mirogabalin.
米拉贝隆是一种新型、选择性α2δ-1 配体，用于治疗神经性疼痛。然而，这种药物并非对所有神经性疼痛患者都有效。因此，我们试图确定能够预测米拉贝隆疗效的因素。本研究纳入了 2019 年 4 月至 11 月期间在我院接受米拉贝隆治疗神经性疼痛的 133 例患者。从病历中提取变量，进行回归分析以确定与神经性疼痛缓解相关的因素。我们在给药后两周评估米拉贝隆的疗效。根据改善程度将患者分为改善差、有效和非常有效组。采用多变量有序逻辑回归分析确定米拉贝隆有效性的预测因素。使用受试者工作特征（ROC）曲线分析阈值。维持剂量[比值比（OR）=0.90；95%置信区间（CI）=0.84-0.98；P=0.01]、阿片类药物（OR=0.26，95%CI=0.08-0.83；P=0.023）和神经生长因子（NTP）（OR=4.78，95%CI=1.04-21.93；P=0.044）的联合使用是与米拉贝隆疗效显著相关的因素。对有效组的 ROC 曲线分析表明，维持剂量≤20 mg/天（曲线下面积[AUC]=0.53）是一个有效预测值。总之，维持剂量（≤20 mg）、阿片类药物和 NTP 的联合使用是预测米拉贝隆有效性的因素。
