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Gabapentinoids for Neuropathic Pain After Spinal Cord Injury: An Updated Meta-Analysis of Randomized Controlled
Rafael Batista João1,2, Jilly Octoria Tagore Chan3, Ewen Shengyao Huang4
1Department of Neurology and Neurophysiology, Goiânia Neurological Institute, Goiânia, GO, Brazil.
Summary
Gabapentinoids effectively reduce central neuropathic pain (CNP) and improve sleep in spinal cord injury (SCI) patients. However, these drugs increase the risk of adverse events like blurred vision and dizziness.
Area of Science:
- Neurology
- Pharmacology
Background:
- Spinal cord injury (SCI) frequently causes central neuropathic pain (CNP), a debilitating condition.
- Gabapentinoids are commonly prescribed for post-SCI CNP, but their optimal use remains uncertain.
Purpose of the Study:
- To assess the efficacy and safety of gabapentinoids versus placebo for treating CNP in patients with SCI.
Main Methods:
- A systematic review of randomized controlled trials (RCTs) was conducted.
- PubMed, Embase, and Cochrane Library databases were searched for studies comparing gabapentinoids (gabapentin, pregabalin, mirogabalin) with placebo.
- Pain intensity, sleep interference, and adverse events were analyzed.
Main Results:
- Five RCTs involving 682 patients were included.
- Gabapentinoids significantly reduced average daily pain and pain-related sleep interference compared to placebo.
- Patients receiving gabapentinoids reported greater pain relief (≥50%) and perceived global improvement, but experienced increased blurred vision, somnolence, peripheral edema, and dizziness.
Conclusions:
- Gabapentinoids demonstrate significant efficacy in alleviating pain and improving sleep in SCI patients with CNP.
- The benefits of gabapentinoids must be weighed against their increased risk of adverse events.
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