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Snedecor SJ, Sudharshan L, Cappelleri JC, et al. Systematic review and comparison of pharmacologic therapies for neuropathic pain associated with spinal cord injury. J Pain Res. 2013;6:539-47doi: 10.2147/JPR.S45966.
Snedecor, S. J., Sudharshan, L., Cappelleri, J. C., Sadosky, A., Desai, P., Jalundhwala, Y. J., & Botteman, M. (2013). Systematic review and comparison of pharmacologic therapies for neuropathic pain associated with spinal cord injury. Journal of pain research, 6539-47. https://doi.org/10.2147/JPR.S45966
Snedecor, Sonya J, et al. "Systematic review and comparison of pharmacologic therapies for neuropathic pain associated with spinal cord injury." Journal of pain research vol. 6 (2013): 539-47. doi: https://doi.org/10.2147/JPR.S45966
Snedecor SJ, Sudharshan L, Cappelleri JC, Sadosky A, Desai P, Jalundhwala YJ, Botteman M. Systematic review and comparison of pharmacologic therapies for neuropathic pain associated with spinal cord injury. J Pain Res. 2013 Jul 11;6:539-47. doi: 10.2147/JPR.S45966. Print 2013. PMID: 23874121; PMCID: PMC3712802.
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J Pain Res. 2013 Jul 11;6:539-47. doi: 10.2147/JPR.S45966. Print 2013.

Systematic review and comparison of pharmacologic therapies for neuropathic pain associated with spinal cord injury.

Journal of pain research

Sonya J Snedecor, Lavanya Sudharshan, Joseph C Cappelleri, Alesia Sadosky, Pooja Desai, Yash J Jalundhwala, Marc Botteman

Affiliations

  1. Pharmerit International, Bethesda, MD, USA.

PMID: 23874121 PMCID: PMC3712802 DOI: 10.2147/JPR.S45966

Abstract

BACKGROUND: Management of neuropathic pain (NeP) associated with spinal cord injury (SCI) is difficult. This report presents a systematic literature review and comparison of the efficacy and safety of pharmacologic therapies for treating SCI-associated NeP.

METHODS: Medline, Embase, Cochrane, and Database of Abstracts of Reviews of Effects were searched through December 2011 for randomized, blinded, and controlled clinical trials of SCI-associated NeP meeting predefined inclusion criteria. Efficacy outcomes of interest were pain reduction on the 11-point numeric rating scale (NRS) or 100 mm visual analog scale and proportion of patients achieving ≥30% or ≥50% pain reduction. Discontinuations and adverse events (AEs) were also assessed, for which Bayesian meta-analytic indirect comparisons were performed.

RESULTS: Of the nine studies included in the analysis, samples were <100 patients, except for one pregabalin study (n = 136). Standard errors for the NRS outcome were often not reported, precluding quantitative comparisons across treatments. Estimated 11-point NRS pain reduction relative to placebo was -1.72 for pregabalin, -1.65 for amitriptyline, -1.0 for duloxetine, -1 (median) for levetiracetam, -0.27 for gabapentin, 1 (median) for lamotrigine, and 2 for dronabinol. Risk ratios relative to placebo for 30% improvement were 0.71 for levetiracetam and 2.56 for pregabalin, and 0.94 and 2.91, respectively, for 50% improvement. Meta-analytic comparisons showed significantly more AEs with pregabalin and tramadol compared with placebo, and no differences between placebo and any treatment for discontinuations.

CONCLUSIONS: Studies of SCI-associated NeP were few, small, and reported insufficient data for quantitative comparisons of efficacy. However, available data suggested pregabalin was associated with more favorable efficacy for all outcome measures examined, and that the risks of AEs and discontinuations were found to be similar among the therapies.

Keywords: indirect comparison; neuropathic pain; pharmacologic management; spinal cord injury; systematic review

References

  1. Arch Phys Med Rehabil. 2010 May;91(5):816-31 - PubMed
  2. Am J Phys Med Rehabil. 1996 Mar-Apr;75(2):84-7 - PubMed
  3. Spinal Cord. 2011 Mar;49(3):365-70 - PubMed
  4. Control Clin Trials. 1996 Feb;17(1):1-12 - PubMed
  5. Pain Pract. 2014 Feb;14(2):167-84 - PubMed
  6. Pain. 2005 Jan;113(1-2):9-19 - PubMed
  7. Am J Phys Med Rehabil. 2010 Oct;89(10):840-8 - PubMed
  8. CNS Drugs. 2008;22(6):455-75 - PubMed
  9. Disabil Rehabil. 2002 Mar 10;24(4):196-202 - PubMed
  10. Ann Phys Rehabil Med. 2009 Mar;52(2):124-41 - PubMed
  11. Arch Phys Med Rehabil. 2007 Dec;88(12):1547-60 - PubMed
  12. Mayo Clin Proc. 2010 Mar;85(3 Suppl):S3-14 - PubMed
  13. Med Oral Patol Oral Cir Bucal. 2012 Sep 01;17(5):e786-93 - PubMed
  14. Clin J Pain. 2009 Mar-Apr;25(3):177-84 - PubMed
  15. Neurology. 2007 Apr 10;68(15):1178-82 - PubMed
  16. Spinal Cord. 2009 Dec;47(12):861-7 - PubMed
  17. Pain. 2008 May;136(1-2):150-7 - PubMed
  18. Pain. 2011 Feb;152(2):267-273 - PubMed
  19. Neurology. 2013 Feb 5;80(6):533-9 - PubMed
  20. Neurology. 2008 Apr 29;70(18):1630-5 - PubMed
  21. Pain Res Manag. 2010 May-Jun;15(3):147-57 - PubMed
  22. BMJ. 2009 Jul 21;339:b2535 - PubMed
  23. Neuroepidemiology. 2010;34(3):184-92; discussion 192 - PubMed
  24. Arch Phys Med Rehabil. 1998 Nov;79(11):1433-9 - PubMed
  25. Spine (Phila Pa 1976). 2004 Apr 1;29(7):743-51 - PubMed
  26. BMJ. 2011 Oct 18;343:d5928 - PubMed
  27. Pain. 2002 Apr;96(3):365-373 - PubMed
  28. Neurology. 2006 Nov 28;67(10):1792-800 - PubMed
  29. J Spinal Cord Med. 2002 Summer;25(2):100-5 - PubMed
  30. Pain. 2002 Apr;96(3):375-383 - PubMed
  31. Eur J Neurol. 2010 Sep;17(9):1113-e88 - PubMed

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