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Effectiveness of Gabapentinoids in Neuropathic Pain: A Single-Center Retrospective Study at a Specialized Institution
Carlos Eduardo Estrada-De La Rosa1, Felipe Alexis Avalos-Salgado2, Nancy Evelyn Navarro-Ruiz3
1Instituto Jalisciense de Alivio al Dolor y Cuidados Paliativos, Secretaria de Salud Jalisco, Zapopan 45150, Mexico.
Background/Objectives:
Gabapentinoids are first-line treatments for neuropathic pain (NP); however, real-world evidence regarding their safety and effectiveness in complex clinical populations remains limited. This study aimed to evaluate the effectiveness and safety profile of gabapentinoid therapy in patients managed within a specialized pain relief institution.
Methods:
A retrospective cohort study (n = 109) was conducted (January 2024 to December 2024). Effectiveness was assessed via DN4 and VAS over one year. Time to improvement was analyzed using Kaplan-Meier curves.
Results:
The cohort (mean age 66.2 ± 15.3 years) presented 100% comorbidity and polypharmacy (66.1% opioids; 67.9% antidepressants). Although all patients showed improvement, only 35.8% achieved "maximal improvement." Pregabalin demonstrated faster VAS reduction than gabapentin (p = 0.029), though long-term success was comparable (p = 0.30). Significantly, 100% of patients reported at least one adverse drug event (ADE), primarily somnolence (66.1%), though no serious ADEs occurred. Lower baseline pain scores were significant predictors of therapeutic success.
Conclusions:
Gabapentinoids are effective for long-term NP management; however, their use is consistently associated with non-serious ADEs. In specialized settings characterized by extensive CNS-active polypharmacy, proactive pharmacovigilance and multidisciplinary oversight are essential to balance analgesic effectiveness with medication safety.
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