Authors: Katherine Clark Stephen J Quinn Matthew Doogue Christine Sanderson Melanie Lovell David C Currow
Publish Date: 2015/07/11
Volume: 23, Issue: 9, Pages: 2517-2520
Abstract
Neuropathic pain is a prevalent and distressing problem faced by people with lifelimiting illness that is often difficult to palliate Gabapentin and pregabalin are widely prescribed as part of the routine approach to palliating neuropathic pain Although they are often viewed as interchangeable agents very little comparative data of their benefits and harms exists in clinical practice Two previously reported pharmacovigilance studies that had used the same methodology for gabapentin and pregabalin were compared These studies examined the benefits and harms of gabapentin and pregabalin after the medications had been routinely prescribed by clinicians working in a network of palliative care services using the same data collection tools with the same definitions and the same time points Data were collected over 21 days from 282 patients prescribed either gabapentin or pregabalin for pain Items included medication doses pain scores and adverse effects In order to compare the medication responses the final doses of pregabalin were converted to gabapentin does equivalents using previously published recommendations The final pain scores were similar for both groups and the reduction in pain were similar OR = 112 95 CI 39 327 p 0001 However this was achieved at lower doses of gabapentin compared to pregabalin Those receiving gabapentin were more likely to experience harms OR = 35 95 CI 14 91 p = 0009 with the reported harms including somnolence ataxia nausea tremor and nystagmus This hypothesisgenerating work strongly supports the need for further trials to best delineate clinical differences in the GABA analoguesThanks go to all the clinicians and the clinical units who have contributed to this programme This includes the following Sunshine Coast Hospital and Health Service QLD Braeside Hospital NSW Calvary Mater Newcastle NSW Calvary Healthcare NSW Greenwich Hospital NSW Wolper Private Hospital NSW Peter MacCallum Cancer Institute VIC St Vincent’s Hospital Melbourne VIC Barwon Health VIC Royal Melbourne Hospital VIC Sir Charles Gardiner Hospital WA Fraser Health British Columbia Canada Hamilton Health Sciences Ontario Canada Capital Health Integrated Palliative Care Service Canada Maria Teresa Chiantore Seràgnoli Hospice Italy Arohanui Hospice New Zealand Humber NHS Foundation Trust UK Leeds Teaching Hospitals NHS Trust UK Haven of Hope Hospital Hong Kong
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