Switching From Pregabalin to Mirogabalin in Patients with Peripheral Neuropathic Pain: A Multi-Center, Prospective,...

Area of Science:

• Neurology
• Pharmacology

Background:

• Mirogabalin, a selective α2δ subunit ligand, is approved for neuropathic pain.
• α2δ ligands like mirogabalin and pregabalin carry risks of adverse events (somnolence, dizziness), impacting patient compliance.
• Limited data exists on switching patients from pregabalin to mirogabalin.

Purpose of the Study:

• To evaluate the safety and efficacy of switching patients with peripheral neuropathic pain from pregabalin to mirogabalin.
• To assess the incidence of key adverse events (somnolence, dizziness, peripheral edema) during the switch.
• To determine the impact of this switch on pain management as measured by the Visual Analog Scale (VAS).

Main Methods:

• Prospective, single-arm, open-label study in 10 Japanese centers.
• 152 patients with peripheral neuropathic pain (VAS ≥ 40 mm) were enrolled.
• A 1-week pregabalin taper was followed by a step-wise mirogabalin titration over 4 weeks, with AE monitoring.

Main Results:

• 136 (89.5%) patients completed the study.
• Incidences of somnolence, dizziness, and peripheral edema were 41.4%, 15.8%, and 2.6%, respectively.
• Mean VAS score significantly decreased by 15.7 mm (p < 0.0001), with >70% achieving effective doses and experiencing mild AEs.

Conclusions:

• Switching from pregabalin to mirogabalin is a well-tolerated and effective strategy for managing peripheral neuropathic pain.
• Step-wise dose titration facilitates successful transition and pain control.
• The study provides valuable safety and efficacy data for this treatment switch.