Analgesic efficacy of gabapentin for fibromyalgia pain

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Analgesic efficacy of gabapentin for fibromyalgia pain

Earlier reviews have evaluated the role of gabapentin for both neuropathic pain (NP) and fibromyalgia. Cooper T E et al., presented a review for both of these conditions separately emphasizing the role of gabapentin in these conditions. Long lasting pain is experienced by the fibromyalgia patients with symptoms like poor sleep, fatigue, depression and reduced quality of life. Gabapentin is an antiepileptic drug widely licensed for the treatment of NP. Although it is not licensed for the treatment of fibromyalgia, it is commonly used, as fibromyalgia can respond to the alike medicines as of NP.

Cooper T E, et al., conducted a study to estimate the analgesic efficacy of gabapentin in fibromyalgia pain in adults and the adverse events related to its use in clinical trials. The  Cochrane Central Register of Controlled Trials (CENTRAL) was explored via the Cochrane Register of Studies Online, MEDLINE via Ovid and Embase via Ovid from inception to 24 May 2016. The reference lists of retrieved studies and reviews were also searched along with the online clinical trial registries.

The study included randomised double-blind trials of eight weeks duration or longer for treating fibromyalgia pain in adults, comparing gabapentin with placebo or an active comparator. The trial quality and the risk of bias was assessed by the two independent authors review along with the data extraction. The dichotomous data was planned to calculate the risk ratio and number required for the treatment of one additional event, using standard methods. A 'summary of findings' table was formed after assessing the evidences using Grading of Recommendations Assessment, Development and Evaluation (GRADE).

Two studies investigated gabapentin in the treatment of fibromyalgia pain. One of the study was presented in previous versions of the review and was inculcated in this one. Another study was put forward as a conference abstract, with insufficient detail to determine the eligibility for inclusion, although it is awaiting assessment. The one included study comprised of 150 participants was a 12-week, multi-center, randomised, double-blind, placebo-controlled and parallel-group study using last-observation-carried-forward imputation for withdrawals. The maximum daily dose was 2400 mg. The overall risk of bias was low, other than the attrition bias.

The outcome of 50% reduction in pain over baseline was not reported at the end of the trial. The outcome of 30% or greater reduction in pain over baseline was attained by 38/75 (49%) participants with gabapentin compared with 23/75 (31%) with placebo (very low quality). A patient global impression of change any category of "better" was attained by 68/75 (91%) with gabapentin and 35/75 (47%) with placebo (very low quality). Nineteen participants withdrew from the study due to adverse events: 12 (16%) in the gabapentin group and 7 (9%) in the placebo group (very low quality). The number of serious adverse events and no deaths were reported (very low quality).

It was culminated that only low-quality evidences were available and were very uncertain about estimates of benefits and harm because of a small amount of data from a single trial. There is lack of evidence to support or refute the suggestion that gabapentin reduces pain in fibromyalgia.

Source:

Cochrane Database of Systematic Reviews

Link to the source:

http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD012188.pub2/full

The original title of the article:

Gabapentin for fibromyalgia pain in adults

Authors

Tess E Cooper et al.

 

SearchTags: 
Therapeutic, Gabapentin, Fibromyalgia, Neck, Buttocks, Shoulder, Arms, Upper back, Chest, Antiepileptic, Efficacy, Safety
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