Suzuki Nobuaki, Yoda Takuya, Nakadai Masato, Takano Takehito, Oinuma Takeo, Kawashima Hiroyuki
Department of Orthopedic Surgery, Niigata University Medical and Dental Hospital, 754 Asahimachi-dori Ichibancho, Chuo-ku, Niigata-shi, Niigata, 951-8520, Japan.
Department of Orthopedic Surgery, Sado General Hospital, 161 Chigusa, Sado City, Niigata, 952-1209, Japan.
J Orthop. 2024 Nov 24;64:102-107. doi: 10.1016/j.jor.2024.11.018. eCollection 2025 Jun.
AIMS & OBJECTIVES: Carpal tunnel syndrome (CTS) is a common condition caused by compression of the median nerve, leading to neuropathic pain such as numbness and nocturnal discomfort, thus impacting daily life. Mirogabalin besylate (MGB), a novel gabapentinoid, shows promise for neuropathic pain, but its efficacy in CTS remains unclear.Therefore, this pilot study aimed to evaluate the short-term clinical outcomes of MGB for CTS.
MATERIALS & METHODS: This retrospective observational study examined 21 patients with CTS who received MGB between April 2022 and March 2023. Evaluations included the Carpal Tunnel Syndrome Instrument (CTSI), Quick Disabilities of the Arm, Shoulder and Hand (Quick DASH), and Visual Analog Scale (VAS) before and 12 weeks after treatment. The primary outcome was the change in CTSI-total. Secondary outcomes included CTSI subparts (symptom severity and functional status), Quick DASH, VAS, and adverse drug reactions (ADRs).
MGB led to significant improvement in CTSI-total (p=0.022), with medium standardized response mean (SRM) and effect size (ES). CTSI-symptom severity (p<0.01) and VAS (p<0.001) also improved, showing medium SRM and ES for CTSI and large SRM and ES for VAS. No significant changes were observed in CTSI-functional status (p=0.349) or Quick DASH (p=0.102). ADRs occurred in 42.9 % of patients, mostly mild.
MGB demonstrated significant short-term efficacy in improving CTS symptoms and reducing pain, though mild ADRs were common. Further studies are needed to assess long-term outcomes and compare MGB with other treatments.
Level IV.
腕管综合征（CTS）是一种由正中神经受压引起的常见病症，会导致如麻木和夜间不适等神经性疼痛，从而影响日常生活。甲磺酸米罗加巴（MGB）是一种新型加巴喷丁类药物，对神经性疼痛显示出前景，但其在CTS中的疗效仍不明确。因此，这项初步研究旨在评估MGB治疗CTS的短期临床结果。
这项回顾性观察研究考察了2022年4月至2023年3月期间接受MGB治疗的21例CTS患者。评估包括治疗前和治疗12周后的腕管综合征量表（CTSI）、手臂、肩部和手部快速残疾评定量表（Quick DASH）以及视觉模拟量表（VAS）。主要结局是CTSI总分的变化。次要结局包括CTSI各部分（症状严重程度和功能状态）、Quick DASH、VAS以及药物不良反应（ADR）。
MGB使CTSI总分显著改善（p = 0.022），标准化反应均值（SRM）和效应量（ES）为中等。CTSI症状严重程度（p < 0.01）和VAS（p < 0.001）也有所改善，CTSI的SRM和ES为中等，VAS的SRM和ES为大。CTSI功能状态（p = 0.349）或Quick DASH（p = 0.102）未观察到显著变化。42.9%的患者出现ADR，大多为轻度。
MGB在改善CTS症状和减轻疼痛方面显示出显著的短期疗效，尽管轻度ADR较为常见。需要进一步研究来评估长期结局并将MGB与其他治疗方法进行比较。
四级。
