Department of Gastroenterology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India.
Department of Neurology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India.
J Gastroenterol Hepatol. 2022 May;37(5):933-937. doi: 10.1111/jgh.15803. Epub 2022 Feb 22.
Restless leg syndrome (RLS) is common in patients with cirrhosis, but its treatment in such patients remains unclear. This pilot study assessed the clinical effectiveness of intravenous iron and a 6-week course of low-dose (75 mg/day) pregabalin for the treatment of RLS in patients with cirrhosis.
It was a prospective, interventional study that included adult patients with cirrhosis and RLS. The participants underwent serum ferritin measurement. Patients with low serum ferritin (< 75 μg/dL) were treated with intravenous iron. Those with normal ferritin levels and those with low levels whose RLS symptoms failed to respond to iron replacement were treated with oral pregabalin, initially 75 mg/day for 6 weeks, followed by 150 mg/day for 6 weeks if there was no response. Recurrence of symptoms was assessed at 6-12 weeks after stopping pregabalin.
Of the 50 patients (male patients 52%; median age 48 [interquartile range: 21-65] years; median Child-Pugh-Turcotte score 8 [5-13] and median Model for End-Stage Liver disease score 17 [12-20]) studied, 29 (58%) had low ferritin; of them, 14 (48%) responded to intravenous iron alone. Eleven of 15 (38%) patients with low ferritin and nonresponse to iron, and 16 of 21 (76%) with normal ferritin levels had a response with low-dose pregabalin. Of the nine nonresponders who received 150 mg/day of pregabalin, four had to discontinue it because of adverse effects.
A short course of low-dose (75 mg/day) pregabalin was effective (82%) in alleviating RLS in patients with cirrhosis. (CTRI/2019/02/017642).
不宁腿综合征（RLS）在肝硬化患者中较为常见，但此类患者的治疗方法仍不明确。本研究旨在评估静脉铁剂和低剂量（75mg/天）普瑞巴林治疗肝硬化患者 RLS 的临床疗效。
这是一项前瞻性干预研究，纳入了肝硬化合并 RLS 的成年患者。所有患者均接受血清铁蛋白检测，铁蛋白水平较低（<75μg/dL）的患者给予静脉铁剂治疗，铁蛋白水平正常或铁剂治疗后 RLS 症状未缓解的低铁蛋白血症患者给予普瑞巴林治疗，起始剂量为 75mg/天，共 6 周，如无效则增加至 150mg/天，再用 6 周。停止普瑞巴林治疗后 6-12 周评估症状复发情况。
50 例患者（男性占 52%；中位年龄 48 岁[21-65]；中位 Child-Pugh-Turcotte 评分为 8 分[5-13]，中位终末期肝病模型评分为 17 分[12-20]）中，29 例（58%）铁蛋白水平较低；其中 14 例（48%）单独应用静脉铁剂治疗有效。15 例铁蛋白水平较低且对铁剂治疗无反应的患者中，11 例（38%）和 21 例铁蛋白水平正常的患者中 16 例（76%）应用低剂量普瑞巴林治疗有效。9 例应用 150mg/天普瑞巴林治疗的无反应患者中，有 4 例因不良反应而停药。
短疗程（75mg/天）低剂量普瑞巴林治疗肝硬化患者 RLS 有效（82%）。（注册号：CTRI/2019/02/017642）。
