Iwasaki Hitoshi, Kato Hiroshi, Koseki Takenao, Kondo Masashi, Yamada Shigeki
Department of Pharmacotherapeutics and Informatics, Fujita Health University School of Medicine, 1-98 Dengakugakubo, Kutsukake-cho, Toyoake, 470-1192, Aichi, Japan.
Department of Development and Education of Clinical Research, Fujita Health University School of Medicine, Toyoake, Aichi, Japan.
J Pharm Health Care Sci. 2025 Jul 1;11(1):54. doi: 10.1186/s40780-025-00464-z.
The gabapentinoids pregabalin and mirogabalin are utilized to treat neuropathic pain, especially in patients with cancer receiving opioid analgesics. Pregabalin combined with strong opioids increases somnolence and dizziness, while mirogabalin causes fewer central adverse events. This study aimed to determine whether mirogabalin leads to a lower incidence of somnolence and dizziness than pregabalin in patients with cancer receiving strong opioids.
We analyzed inpatients with cancer treated with mirogabalin or pregabalin along with strong opioids at Fujita Health University Hospital (April 2019–December 2023) and assessed cumulative incidence rates, hazard ratios (HRs) for somnolence and dizziness occurrence, and changes in morphine milligram equivalents (MMEs).
Among the 89 patients included in the analysis (mirogabalin: 39, pregabalin: 50), the median time to somnolence and dizziness was significantly shorter in the mirogabalin group than in the pregabalin group (8.0 vs. 17.0 days, = 0.039). The multivariable Cox proportional regression model showed a higher risk with mirogabalin, although with no significance (HR: 1.74, = 0.117). MMEs increased in the pregabalin group but not in the mirogabalin group.
Mirogabalin and pregabalin contribute to somnolence and dizziness in patients receiving strong opioids, necessitating careful monitoring.
The online version contains supplementary material available at 10.1186/s40780-025-00464-z.
加巴喷丁类药物普瑞巴林和米罗加巴林用于治疗神经性疼痛，尤其是接受阿片类镇痛药的癌症患者。普瑞巴林与强效阿片类药物联合使用会增加嗜睡和头晕，而米罗加巴林引起的中枢性不良事件较少。本研究旨在确定在接受强效阿片类药物治疗的癌症患者中，米罗加巴林导致嗜睡和头晕的发生率是否低于普瑞巴林。
我们分析了藤田保健大学医院（2019年4月至2023年12月）接受米罗加巴林或普瑞巴林联合强效阿片类药物治疗的癌症住院患者，并评估了嗜睡和头晕的累积发生率、发生的风险比（HR）以及吗啡毫克当量（MME）的变化。
在纳入分析的89例患者中（米罗加巴林组：39例，普瑞巴林组：50例），米罗加巴林组嗜睡和头晕的中位时间明显短于普瑞巴林组（8.0天对17.0天，P = 0.039）。多变量Cox比例回归模型显示米罗加巴林的风险较高，尽管无统计学意义（HR：1.74，P = 0.117）。普瑞巴林组的MME增加，而米罗加巴林组未增加。
米罗加巴林和普瑞巴林会导致接受强效阿片类药物治疗的患者出现嗜睡和头晕，需要仔细监测。
在线版本包含可在10.1186/s40780-025-00464-z获取的补充材料。
