Open AccessGabapentin for acute pain in sickle cell disease: A randomized double‐blinded placebo‐controlled phase II clinical trial
Author(s) -
Puri Latika,
Nottage Kerri,
Hankins Jane S.,
Wang Winfred C.,
McGregor Olivia,
Gossett Jeffrey M.,
Kang Guolian,
Anghelescu Doralina L.
Publication year - 2021
Publication title -
ejhaem
Language(s) - English
Resource type - Journals
ISSN - 2688-6146
DOI - 10.1002/jha2.188
Subject(s) - gabapentin , double blinded , medicine , placebo , clinical trial , disease , randomized controlled trial , phases of clinical research , physical therapy , pathology , alternative medicine
Pain in sickle cell disease (SCD) can have a neuropathic component. This randomized phase II double‐blinded placebo‐controlled study evaluated the efficacy of gabapentin in reducing pain and opioid consumption (morphine‐equivalent dose [MED]) during acute vaso‐occlusive crisis (VOC). Of 90 patients aged 1–18 years with VOC pain, 45 were randomized to a single gabapentin dose (15 mg/kg) and 45 to placebo, in addition to standard treatment; 42 and 44 patients were evaluable in the gabapentin and placebo arms, respectively. A decrease in pain of ≥33% was reported in 68% of patients in the gabapentin arm and 60% of those in the placebo arm (one‐sided p = 0.23). The median MED (mg/kg) in the gabapentin (0.12) and placebo arms (0.13) was similar ( p = 0.9). However, in the subset of patients with the HbSS genotype ( n = 45), the mean (SD) absolute pain score decrease by the time of discharge was significantly greater in the gabapentin arm (5.9 [3.5]) than in the placebo arm (3.6 [3.3]) ( p = 0.032). Pain scores in the overall study population were not significantly reduced when gabapentin was added to standard treatment; however, gabapentin benefited individuals with the more severe genotype, HbSS, during acute VOC. Larger, prospective studies are needed to confirm these findings.