Baron Ralf, Brunnmüller Ulrike, Brasser Matthias, May Michael, Binder Andreas
Division of Neurological Pain Research and Therapy, Department of Neurology, University Hospital of Schleswig-Holstein, Campus Kiel, Schittenhelmstr. 10, D-24105 Kiel, Germany.
Eur J Pain. 2008 Oct;12(7):850-8. doi: 10.1016/j.ejpain.2007.12.004. Epub 2008 Jan 31.
We assessed the efficacy and safety of a flexible-dose pregabalin regimen in patients with diabetic peripheral neuropathy (DPN) or postherpetic neuralgia (PHN) under clinical practice conditions. Further, the trial investigated the correlation of unspecific measures of change (patient and physician global impression of change, PGIC and CGIC) and specific measures of morbidity. The primary outcomes of this prospective, open-label, non-controlled study were the correlation between global status (PGIC and CGIC) and changes in pain, sleep, and anxiety scores as assessed on numerical or visual rating scales. A total of 217 outpatients were included in 53 centres. The most frequently used dosing regimen involved a starting dose of 150mg/d and dose escalation to 300mg/d after one week (mean: 301mg/d, administered in two doses). The significant changes on pain, sleep and anxiety scales (-40%, -43%, -42%) between baseline and study end after 4-week pregabalin treatment were paralleled by the changes in ratings in both the PGIC and CGIC. The correlation with both PGIC and CGIC was 0.60 for pain, 0.51 for sleep and 0.20 or 0.13 for the correlation of anxiety with PGIC and CGIC, respectively. All correlations with exception of the pair CGIC/anxiety reached statistical significance. In conclusion, pregabalin in a flexible-dose regimen improved pain, sleep, anxiety and general state, and was well tolerated. The efficacy and safety profile of pregabalin was consistent with the data from the controlled clinical trials. The PGIC and CGIC and the specific pain and sleep scores, but not the anxiety score were generally well correlated but not synonymous.
我们在临床实践条件下评估了灵活剂量普瑞巴林方案对糖尿病性周围神经病变(DPN)或带状疱疹后神经痛(PHN)患者的疗效和安全性。此外,该试验研究了非特异性变化指标(患者和医生的整体变化印象,PGIC和CGIC)与发病率特异性指标之间的相关性。这项前瞻性、开放标签、非对照研究的主要结局是整体状况(PGIC和CGIC)与通过数字或视觉评分量表评估的疼痛、睡眠和焦虑评分变化之间的相关性。53个中心共纳入了217名门诊患者。最常用的给药方案是起始剂量为150mg/d,一周后剂量增至300mg/d(平均:301mg/d,分两次给药)。普瑞巴林治疗4周后,基线与研究结束时疼痛、睡眠和焦虑量表上的显著变化(分别为-40%、-43%、-42%)与PGIC和CGIC评分的变化平行。疼痛与PGIC和CGIC的相关性均为0.60,睡眠与二者的相关性为0.51,焦虑与PGIC和CGIC的相关性分别为0.20或0.13。除CGIC/焦虑这一对外,所有相关性均达到统计学显著性。总之,灵活剂量方案的普瑞巴林改善了疼痛、睡眠、焦虑和总体状态,且耐受性良好。普瑞巴林的疗效和安全性概况与对照临床试验的数据一致。PGIC和CGIC与特定的疼痛和睡眠评分总体上相关性良好,但不是同义词,而焦虑评分与它们的相关性不佳。