Raffaeli William, Felzani Giorgio, Tenti Michael, Greco Luca, D'Eramo Maria Pia, Proietti Stefania, Morone Giovanni
ISAL Foundation, Institute for Research on Pain, 47921 Rimini, Italy.
San Raffaele Institute of Sulmona, 67039 Sulmona, Italy.
Healthcare (Basel). 2023 Sep 16;11(18):2563. doi: 10.3390/healthcare11182563.
Gabapentinoids are first choice drugs for central neuropathic pain (CNP) despite limited evidence of efficacy and side effects affecting therapy outcomes. Nutraceuticals could improve their efficacy and tolerability. Our aim is to investigate the effect of NACVAN, in addition to gabapentinoids, on pain symptomatology in CNP patients. The effect of 6 weeks of treatment of NACVAN was preliminary observed among 29 adult inpatients with spinal cord injury (SCI) or stroke-related CNP recruited to the experimental group. Pain intensity, neuropathic pain, and quality-of-life were measured at baseline (T0) and after 3 (T1) and 6 weeks (T2). Change in each outcome over time was assessed through a repeated measures analysis of variance or Wilcoxon matched-pairs test. Preliminary results show a significant reduction in pain intensity (T0 → T1, = 0.021; T0 → T2, = 0.011; T1 → T2, = 0.46), neuropathic symptoms (T0 → T1, = 0.024; T0 → T2, = 0.003), and evoked pain (T0 → T2, = 0.048). There were no significant reductions in other neuropathic pain dimensions and in quality-of-life components. No side-effects were detected. NACVAN could have a beneficial adjuvant effect when used as an add-on to gabapentinoids in patients suffering from CNP due to SCI or stroke, with no adverse effect. Future analysis on a larger sample, compared with a placebo condition, could confirm these preliminary results.
尽管加巴喷丁类药物治疗中枢性神经病理性疼痛(CNP)的疗效和副作用证据有限,但仍是首选药物。营养保健品可提高其疗效和耐受性。我们的目的是研究除加巴喷丁类药物外,NACVAN对CNP患者疼痛症状的影响。在招募到实验组的29例因脊髓损伤(SCI)或中风相关CNP的成年住院患者中,初步观察了NACVAN治疗6周的效果。在基线(T0)、3周(T1)和6周(T2)后测量疼痛强度、神经病理性疼痛和生活质量。通过重复测量方差分析或Wilcoxon配对检验评估每个结果随时间的变化。初步结果显示,疼痛强度(T0→T1,P = 0.021;T0→T2,P = 0.011;T1→T2,P = 0.46)、神经病理性症状(T0→T1,P = 0.024;T0→T2,P = 0.003)和诱发性疼痛(T0→T2,P = 0.048)均显著降低。其他神经病理性疼痛维度和生活质量成分没有显著降低。未检测到副作用。对于因SCI或中风导致CNP的患者,NACVAN作为加巴喷丁类药物的附加用药可能具有有益的辅助作用,且无不良反应。与安慰剂对照相比,未来对更大样本的分析可能会证实这些初步结果。