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Efficacy and safety of gabapentin 1800 mg treatment for post‐herpetic neuralgia: a meta‐analysis of randomized controlled trials
Author(s) -
Fan H.,
Yu W.,
Zhang Q.,
Cao H.,
Li J.,
Wang J.,
Shao Y.,
Hu X.
Publication year - 2014
Publication title -
journal of clinical pharmacy and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.622
H-Index - 73
eISSN - 1365-2710
pISSN - 0269-4727
DOI - 10.1111/jcpt.12167
Subject(s) - gabapentin , medicine , placebo , confidence interval , randomized controlled trial , relative risk , anesthesia , meta analysis , neuralgia , somnolence , adverse effect , odds ratio , neuropathic pain , alternative medicine , pathology
Summary What is known and objective Gabapentin has been used for the management of post‐herpetic neuralgia ( PHN ). However, inconsistent results have been reported. This meta‐analysis was performed to assess the efficacy and safety of gabapentin 1800 mg/day in PHN patients by conducting a meta‐analysis. Methods Electronic databases were searched for relevant randomized controlled trials ( RCT s) that compared gabapentin 1800 mg/day to placebo for PHN . The primary outcomes were reduction in 24‐h average pain intensity scores, 50% and 30% pain intensity reduction and gabapentin‐related side effects. The secondary outcomes were reduction in sleep rating scores and improvement in Patient Global Impression of Change ( PGIC ) or Clinician Global Impression of Change ( CGIC ). Results and discussion Six RCT s were included. Gabapentin 1800 mg/day reduced the 24‐h average pain intensity scores [standard mean differences ( SMD ) −0·50; 95% confidence interval ( CI ) −0·88, −0·13; I 2 = 86·3%] and average daily sleep rating scores [weighted mean differences ( WMD ) −0·71; 95% CI −1·11, −0·32; I 2 = 0%]. Gabapentin treatment yielded an improvement in pain intensity (risk ratio ( RR ) 1·88; 95% CI 1·35, 2·29; I 2 = 64·8%; for 50% reduction and RR 1·43; 95% CI 1·12, 1·83; I 2 = 0% for 30% reduction, respectively), PGIC ( RR 1·49; 95% CI 1·28, 1·74; I 2 = 0%), and CGIC ( RR 1·58; 95% CI 1·29, 1·92; I 2 = 30·9%). However, gabapentin increased the somnolence ( RR 2·03; 95% CI 1·39, 2·98; I 2 = 2%), dizziness ( RR 2·68; 95% CI 1·95, 3·69; I 2 = 15%), peripheral oedema ( RR 9·10; 95% CI 3·23, 25·60; I 2 = 2%), total adverse effects ( RR 1·28; 95% CI 1·16, 1·42; I 2 = 0%) and withdrawal due to adverse events ( RR 1·51; 95% CI 1·06, 2·16; I 2 = 6%), but these adverse effects were often mild to moderate. What is new and conclusion Treatment with gabapentin 1800 mg/day yielded a significant reduction in PHN up to 14 weeks. Gabapentin 1800 mg appeared safe in treating PHN for up to 24 weeks.