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Gabapentina para el dolor neuropático crónico

Andrew Moore1, Sheena Derry1, Philip Wiffen1

  • 1Pain Research and Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, England.

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|February 28, 2018
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Resumen

La gabapentina ofrece un alivio moderado del dolor en condiciones de dolor neuropático crónico como la neuralgia postherpética y la neuropatía diabética dolorosa. Este medicamento mostró una reducción del dolor del 50% en un pequeño porcentaje de pacientes más que el placebo.

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Área de la Ciencia:

  • Neurología
  • Farmacología
  • Medicina para el dolor

Sus antecedentes:

  • El dolor neuropático crónico afecta a millones en todo el mundo.
  • La neuralgia postherpética (PHN) y la neuropatía diabética dolorosa (PDN) son afecciones debilitantes comunes.
  • La gabapentina es un medicamento anticonvulsivo ampliamente prescrito.

Objetivo del estudio:

  • Evaluar la eficacia de la gabapentina en el tratamiento del dolor neuropático moderado a severo.
  • Determinar la asociación entre el uso de gabapentina y la reducción del dolor en pacientes con NPH o NPD.

Principales métodos:

  • Revisión sistemática y metanálisis de ensayos controlados aleatorios.
  • Inclusión de pacientes con dolor neuropático moderado o severo.
  • Rango de dosis: entre 1200 y 3600 mg/día durante 4 a 12 semanas.

Principales resultados:

  • El uso de gabapentina se asoció con un aumento estadísticamente significativo de pacientes que lograron una reducción del dolor de al menos un 50% en comparación con el placebo.
  • La diferencia absoluta en las tasas de respuesta osciló entre el 14% y el 17% en favor de la gabapentina.
  • El efecto se observó en pacientes con NPH y NPD.

Conclusiones:

  • Gabapentin demuestra un beneficio modesto en la reducción del dolor en personas con dolor neuropático crónico.
  • Los hallazgos apoyan el uso de gabapentina como opción de tratamiento para PHN y PDN.
  • La investigación adicional puede explorar la dosificación óptima y la eficacia a largo plazo.