Pregabalin for the management of neuropathic pain in adults with cancer: a systematic review of the literature.

OBJECTIVE: To systematically identify and appraise the current literature of pregabalin in the treatment of neuropathic pain resulting from cancer or cancer treatment. DESIGN: A systematic review of the literature was conducted based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses. INTERVENTIONS AND SUBJECTS: Studies reporting pregabalin data for adult (>18 years) patients with cancer experiencing neuropathic pain due to cancer or cancer treatment/surgery were considered eligible for inclusion. METHODS: A literature search was conducted in PubMed on February 22, 2012 using the following search terms: "neuropath* AND pain AND cancer OR oncology OR tumor OR tumour AND pregabalin." Open access journals were also searched. Abstracts were screened and reviewed for eligibility based on predetermined criteria for inclusion. Data reporting pain intensity, pain interference, quality of life, symptom quality and intensity, global impression of change, treatment satisfaction, and adverse effects were the predefined factors for analysis. Data were summarized descriptively due to variations in study outcome measures. RESULTS: Five articles were eligible for inclusion; one double-blind National Cancer Institute common toxicity criteria controlled trial, one single-arm open-label study, two observational analyses, and one case report. CONCLUSIONS: There were limited published data reporting efficacy and safety outcomes for pregabalin in the treatment of neuropathic pain in adult patients with cancer. Due to limitations within the studies included in this review, it is not possible to draw any conclusions on the descriptive summary of pregabalin for the treatment of cancer-related neuropathic pain, and further studies are required.

Relationships between changes in pain severity and other patient-reported outcomes: an analysis in patients with posttraumatic peripheral neuropathic pain.

BACKGROUND: The objective of this study is to use the pain numeric rating scale (NRS) to evaluate associations between change in pain severity and changes in sleep, function, and mood assessed via patient-reported outcomes (PROs) in patients with posttraumatic pain. METHODS: This is a secondary analysis of a clinical trial evaluating pregabalin in patients with posttraumatic peripheral neuropathic pain (N = 254). Regression models were used to determine associations between changes in pain (0-10 NRS) as the predictor and scores on the following PRO measures as the outcome: Pain Interference Index; Hospital Anxiety and Depression Scale anxiety and depression subscales; Medical Outcomes Study-Sleep Scale 9-item Sleep Problems Index and Sleep Disturbance subscale; and Daily Sleep Interference Scale (0-10 NRS). RESULTS: Change in pain severity showed clear, direct relationships with changes in function, anxiety, depression, and sleep PROs, all of which were statistically significant (P <.001). Results from subgroup analyses (≥30% or ≥50% pain responders, pregabalin or placebo treatment, age ≤ 51 years or > 51 years) tended to be consistent with results from the overall sample. CONCLUSIONS: Overall, a direct relationship exists between pain and various aspects of patient's well-being and functioning, which can provide a quantitative assessment of how improvements in pain may be expected to relate to other patient outcomes. (http://ClinicalTrials.gov Identifier number NCT00292188; EudraCT #2005-003048-78).