Marcianò Gianmarco, Siniscalchi Antonio, Di Gennaro Gianfranco, Rania Vincenzo, Vocca Cristina, Palleria Caterina, Catarisano Luca, Muraca Lucia, Citraro Rita, Evangelista Maurizio, De Sarro Giovambattista, D'Agostino Bruno, Abrego-Guandique Diana Marisol, Cione Erika, Morlion Bart, Gallelli Luca
Operative Unit of Clinical Pharmacology and Pharmacovigilance, Renato Dulbecco University Hospital, Viale Europa, 88100 Catanzaro, Italy.
Department of Neurology and Stroke Unit, Annunziata Hospital of Cosenza, Via Della Repubblica, 87100 Cosenza, Italy.
J Clin Med. 2024 Sep 24;13(19):5682. doi: 10.3390/jcm13195682.
Neuropathic pain is defined as pain induced by a lesion or disease of the somatosensory nervous system. Pharmacological and non-pharmacological treatments are frequently employed. In the current clinical investigation, we assessed the effects of sex on the safety and effectiveness of medications used to treat neuropathic pain. We conducted a prospective analysis between 1 February 2021 and 20 April 2024, involving patients with neuropathic pain referred to the Ambulatory of Pain Medicine of "Renato Dulbecco" University Hospital in Catanzaro (Calabria, Italy). Patients over 18 years old with signs of neuropathic pain (Douleur Neuropathique en 4 questionnaire ≥ 4) were included. Exclusion criteria comprised patients with Alzheimer's disease; patients with nociplastic or nociceptive pain; and patients with neoplasms. Patients with fewer than two accesses to ambulatory care were excluded, as were those who did not sign the informed consent. Clinical data were collected from each enrolled patient and subsequently analyzed, considering clinical outcomes. Sex and gender differences in efficacy were estimated using multivariate linear modeling and propensity-score matching. During the study, 531 patients were screened, and 174 were enrolled (33.5%, mean age 61.5 ± 13.1; 64 males and 110 females, mean age 60.6 ± 13.4 and 61.96 ± 13.0) in accordance with the inclusion and exclusion criteria. Only minor differences in treatment prescription were observed based on age, body mass index, and comorbidities. Smoking, sex, educational level, and body mass index did not induce a significant change in pain perception. Males required slightly higher, though not significantly, doses of drugs for pain control than females. The treatment was not significantly more effective for females than for males. Females did not exhibit a significantly lower number of adverse drug reactions compared to males. The current study found that there are no appreciable differences between the sexes when it comes to the treatment of neuropathic pain.
神经病理性疼痛被定义为由躯体感觉神经系统的损伤或疾病引起的疼痛。药物治疗和非药物治疗经常被采用。在当前的临床研究中，我们评估了性别对用于治疗神经病理性疼痛药物的安全性和有效性的影响。我们在2021年2月1日至2024年4月20日期间进行了一项前瞻性分析，纳入了转诊至意大利卡坦扎罗（卡拉布里亚）“雷纳托·杜尔贝科”大学医院疼痛医学门诊的神经病理性疼痛患者。纳入18岁以上有神经病理性疼痛体征（神经病理性疼痛4问卷≥4）的患者。排除标准包括患有阿尔茨海默病的患者；患有伤害感受性或伤害感受性疼痛的患者；以及患有肿瘤的患者。排除门诊就诊次数少于两次的患者，以及未签署知情同意书的患者。从每位纳入研究的患者收集临床数据，随后考虑临床结果进行分析。使用多变量线性建模和倾向得分匹配评估疗效方面的性别差异。在研究期间，根据纳入和排除标准，共筛选了531例患者，174例患者被纳入研究（33.5%，平均年龄61.5±13.1岁；男性64例，女性110例，平均年龄分别为60.6±13.4岁和61.96±13.0岁）。基于年龄、体重指数和合并症，仅观察到治疗处方上的微小差异。吸烟、性别、教育水平和体重指数并未引起疼痛感知的显著变化。男性控制疼痛所需的药物剂量略高于女性，但差异不显著。该治疗对女性的效果并不比对男性显著更有效。与男性相比，女性并未表现出明显更少的药物不良反应。当前研究发现，在神经病理性疼痛的治疗方面，两性之间没有明显差异。
