Wang Zhihui, Naeem Iffat, Oyenola Tinu, Khan Ahmad Raza, Dennis Amanda, Obamiyi Samuel, Toews Emilie, Singh Shilpa, Zhu Gebin
Research, Health Research Partners, Calgary, CAN.
Orofacial Pain, University of Rochester School of Medicine and Dentistry, Rochester, USA.
Cureus. 2024 Sep 29;16(9):e70443. doi: 10.7759/cureus.70443. eCollection 2024 Sep.
Neuropathic pain (NeP) arises from pathologies of the nervous system, significantly impacting patient functionality and quality of life. Pregabalin is a first-line treatment for NeP, but there has been limited focus on patient-reported outcomes (PROs). This systematic review synthesizes PROs from clinical studies assessing pregabalin's efficacy in treating NeP, with a focus on sleep disturbance, mental health, and health-related quality of life (HRQOL). Following Cochrane Collaboration guidelines, we conducted a systematic search of randomized controlled trials and epidemiological studies reporting PROs associated with pregabalin treatment for NeP. Sixteen studies met the inclusion criteria and were narratively synthesized. The findings indicate that pregabalin significantly improved sleep interference and HRQOL across multiple studies, particularly at doses of 300 mg/day or higher. However, improvements in mental health outcomes, such as anxiety and depression, were inconsistent across studies. No meta-analysis was conducted due to the heterogeneity of outcomes. In conclusion, while pregabalin shows robust efficacy in reducing NeP-related sleep disturbances, its effects on mental health and HRQOL are less consistent. These findings highlight the need for a more holistic approach to NeP treatment, incorporating both clinical outcomes and PROs.
神经性疼痛(NeP)源于神经系统的病变,对患者的功能和生活质量有重大影响。普瑞巴林是治疗NeP的一线药物,但对患者报告结局(PROs)的关注有限。本系统评价综合了评估普瑞巴林治疗NeP疗效的临床研究中的PROs,重点关注睡眠障碍、心理健康和健康相关生活质量(HRQOL)。按照Cochrane协作网指南,我们对报告与普瑞巴林治疗NeP相关的PROs的随机对照试验和流行病学研究进行了系统检索。16项研究符合纳入标准并进行了叙述性综合分析。研究结果表明,在多项研究中,普瑞巴林显著改善了睡眠干扰和HRQOL,尤其是在每日剂量300毫克或更高时。然而,研究中关于焦虑和抑郁等心理健康结局的改善情况并不一致。由于结局的异质性,未进行荟萃分析。总之,虽然普瑞巴林在减少与NeP相关的睡眠障碍方面显示出强大的疗效,但其对心理健康和HRQOL的影响不太一致。这些发现凸显了采用更全面的方法治疗NeP的必要性,将临床结局和PROs都纳入其中。