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PredicateObject
rdf:type
lifeskim:mentions
pubmed:issue
11
pubmed:dateCreated
2008-11-5
pubmed:abstractText
Time to onset of pain relief and improvement in allodynia in 269 patients with postherpetic neuralgia was examined in a 4-week randomized trial comparing flexibly dosed pregabalin (150-600 mg/d), fixed-dose pregabalin (300 mg/d), and placebo. For each patient with clinically meaningful pain reduction (>or=30%) at end point, onset of pain relief was defined as the first study day on which a patient reported >or=1-point reduction in pain relative to baseline. Average dose achieved was 396 mg/d in the flexible-dose group compared with 295 mg/d in the fixed-dose group. Median pain relief onset times were 3.5 days (flexible-dose), 1.5 days (fixed-dose), and >4 weeks (placebo). Compared with placebo, significantly more patients in both pregabalin treatment groups achieved >or=30% and >or=50% pain reduction at end point. Almost 95% of patients had brush-evoked allodynia, with 68% having moderate to severe allodynia (>or=40/100 mm). At baseline, pain and allodynia were highly correlated. Independent of treatment assignment, improvement in pain and improvement in allodynia were significantly correlated. Allodynia could serve as a useful surrogate outcome measure in future studies. Pregabalin was significantly better than placebo in alleviating allodynia (flexible-dose reduction, 26 mm; fixed-dose, 21 mm; placebo, 12 mm). Discontinuation rates due to adverse events were more frequent in the fixed-dose group. PERSPECTIVE: A flexible-dose regimen reduces discontinuations, facilitates higher final doses, and results in a slightly greater pain relief. Allodynia (touch-evoked pain) can be of disabling severity and is present in nearly all patients with postherpetic neuralgia. Allodynia severity is correlated with pain severity and improvement in allodynia is correlated with clinical response.
pubmed:language
eng
pubmed:journal
pubmed:citationSubset
IM
pubmed:chemical
pubmed:status
MEDLINE
pubmed:month
Nov
pubmed:issn
1528-8447
pubmed:author
pubmed:issnType
Electronic
pubmed:volume
9
pubmed:owner
NLM
pubmed:authorsComplete
Y
pubmed:pagination
1006-17
pubmed:meshHeading
pubmed-meshheading:18640074-Adult, pubmed-meshheading:18640074-Aged, pubmed-meshheading:18640074-Aged, 80 and over, pubmed-meshheading:18640074-Analgesics, pubmed-meshheading:18640074-Analysis of Variance, pubmed-meshheading:18640074-Dose-Response Relationship, Drug, pubmed-meshheading:18640074-Double-Blind Method, pubmed-meshheading:18640074-Drug Administration Schedule, pubmed-meshheading:18640074-Female, pubmed-meshheading:18640074-Humans, pubmed-meshheading:18640074-Male, pubmed-meshheading:18640074-Middle Aged, pubmed-meshheading:18640074-Neuralgia, Postherpetic, pubmed-meshheading:18640074-Pain Measurement, pubmed-meshheading:18640074-Placebos, pubmed-meshheading:18640074-Severity of Illness Index, pubmed-meshheading:18640074-Treatment Outcome, pubmed-meshheading:18640074-gamma-Aminobutyric Acid
pubmed:year
2008
pubmed:articleTitle
Pregabalin for postherpetic neuralgia: placebo-controlled trial of fixed and flexible dosing regimens on allodynia and time to onset of pain relief.
pubmed:affiliation
Oregon Health and Science University, Comprehensive Pain Center, Portland, Oregon, USA.
pubmed:publicationType
Journal Article, Randomized Controlled Trial, Multicenter Study