Akazawa Tsutomu, Inoue Gen, Tanaka Masahiro, Umehara Tasuku, Nagai Toshihiro, Oshita Yusuke, Imura Takayuki, Miyagi Masayuki, Saito Wataru, Sako Kosuke, Nomura Satoshi, Hiyama Akihiko, Katoh Hiroyuki, Sakai Daisuke, Sato Masato, Yoshida Atsuhiro, Iinuma Masahiro, Niki Hisateru, Takaso Masashi, Watanabe Masahiko
Department of Orthopaedic Surgery, St. Marianna University School of Medicine, Kawasaki, Kanagawa, Japan.
Kanagawa Spine Research Society, Isehara, Kanagawa, Japan.
Global Spine J. 2023 Jun;13(5):1319-1324. doi: 10.1177/21925682211031185. Epub 2021 Jul 30.
Multicenter retrospective study.
To investigate adverse events (AEs) in patients with neuropathic pain related to lumbar disease who switched to mirogabalin from pregabalin.
This study surveyed the records of 82 patients with peripheral neuropathic leg pain related to lumbar disease who switched to mirogabalin from pregabalin. We evaluated AEs associated with pregabalin and mirogabalin, the continuation rate of mirogabalin, and the pain-relieving effect at 4 weeks after switching from pregabalin to mirogabalin. We compared patients who switched due to lack of efficacy (LoE group) and patients who switched due to AEs (AE group).
The incidence rates of somnolence and dizziness with pregabalin were 12.2% and 14.6%, respectively, while the incidence rates with mirogabalin were reduced to 7.3% for somnolence and 4.9% for dizziness. The incidence of AEs with pregabalin was significantly higher in the AE group (LoE group: 11.1%, AE group 100%), especially for somnolence (LoE group: 3.2%, AE group: 47.1%) and dizziness (LoE group: 4.8%, AE: 52.9%). After switching, the incidences of AEs with mirogabalin were not significantly different between the 2 groups (LoE group: 15.9%, AE group: 23.5%), including for somnolence (LoE group: 7.9%, AE group: 5.9%) and dizziness (LoE group: 4.8%, AE group: 5.9%). There were no significant differences in continuation rate of mirogabalin or the pain-relieving effect between groups.
The patients who experience somnolence and dizziness with pregabalin might be able to continue safely receiving treatment for their pain by switching to mirogabalin.
多中心回顾性研究。
调查从普瑞巴林换用米罗加巴林的腰椎疾病相关性神经病理性疼痛患者的不良事件（AE）。
本研究调查了82例从普瑞巴林换用米罗加巴林的腰椎疾病相关性外周神经病理性腿痛患者的记录。我们评估了与普瑞巴林和米罗加巴林相关的AE、米罗加巴林的持续治疗率以及从普瑞巴林换用米罗加巴林4周后的止痛效果。我们比较了因疗效不佳而换药的患者（疗效不佳组）和因AE而换药的患者（AE组）。
普瑞巴林引起的嗜睡和头晕发生率分别为12.2%和14.6%，而米罗加巴林引起的嗜睡和头晕发生率分别降至7.3%和4.9%。AE组中普瑞巴林引起的AE发生率显著更高（疗效不佳组：11.1%，AE组：100%），尤其是嗜睡（疗效不佳组：3.2%，AE组：47.1%）和头晕（疗效不佳组：4.8%，AE组：52.9%）。换药后，两组米罗加巴林引起的AE发生率无显著差异（疗效不佳组：15.9% AE组：23.5%），包括嗜睡（疗效不佳组：7.9%，AE组：5.9%）和头晕（疗效不佳组：4.8%，AE组：5.9%）。两组间米罗加巴林的持续治疗率或止痛效果无显著差异。
使用普瑞巴林出现嗜睡和头晕的患者换用米罗加巴林后可能能够安全地继续接受疼痛治疗。
