Monodosis diara de gabapentina en el tratamiento de neuralgia postherpética: una revisión
Gabapentin for once-daily treatment of post-herpetic neuralgia: a review.
Beal B, Moeller-Bertram T, Schilling JM, Wallace MS.
Division of Pain Medicine, Department of Anesthesiology, University of California, San Diego, CA, USA.
Clin Interv Aging. 2012;7:249-55. Epub 2012 Jul 12.
Abstract
Post-herpetic neuralgia is a neuropathic pain syndrome resulting from an insult to the peripheral and central nervous systems caused by the varicella zoster virus. Spontaneous pain may result in the persistent sensation of burning, tingling, or aching and may be associated with thermally or mechanically provoked pain, resulting in hyperalgesia or allodynia. The majority of cases occur in patients over the age of 50 years. Gabapentin is a structural analog of gamma aminobutyric acid that binds to the α(2)-δ site of voltage-dependent calcium channels and modulates the influx of calcium, with a resulting reduction in excitatory neurotransmitter release. Gabapentin is effective in reducing neuropathic pain due to post-herpetic neuralgia when given at least three times per day, due to its short half-life, resulting in demonstrable fluctuations in plasma levels. Gabapentin has dose-limiting side effects that prevent some patients from achieving therapeutic plasma levels, such as somnolence (27.4%), dizziness (23.9%), and ataxia (7.1%). Gralise™ is a once-daily extended-release formulation of gabapentin that has been developed using AcuForm™ technology. AcuForm is a polymer-based drug delivery system that retains the tablet in the stomach and upper gastrointestinal tract for a sustained period of time. Once-daily dosing has been shown to provide comparable drug exposure with an identical daily dose of the immediate-release formulation when administered three times daily. Participants given Gralise 1800 mg daily had a statistically significant reduction in average daily pain intensity scores compared with placebo, reduced sleep interference due to pain, and a greater percent of participants reporting being much or very much improved on the patient global impression of change. An analysis comparing the efficacy and safety profiles in the aging population (≥65 years) with those younger than 65 years showed that Gralise is effective and well tolerated in both age groups.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3410680/pdf/cia-7-249.pdf
http://www.dovepress.com/gabapentin-for-once-daily-treatment-of-post-herpetic-neuralgia-a-revie-peer-reviewed-article-CIA
Tolerabilidad y seguridad de las tabletas gastroretentivas de gabapentina para dosis diaria en el manejo de la neuralgia postherpética
Tolerability and safety of gastroretentive once-daily gabapentin tablets for the treatment of postherpetic neuralgia.
Irving GA, Sweeney M.
Swedish Pain and Headache Center, Seattle, WA, USA.
J Pain Res. 2012;5:203-8. Epub 2012 Jun 25.
Abstract
OBJECTIVE: An immediate-release formulation of gabapentin is approved for treatment of postherpetic neuralgia (PHN). This formulation, however, requires multiple daily dosing, usually three times per day, and is associated with a high incidence of somnolence and dizziness. We assessed the tolerability and safety of a once-daily gastroretentive formulation of gabapentin (G-GR) in phase 3 clinical trials in patients with PHN.RESEARCH DESIGN AND METHODS: Data were pooled from two placebo-controlled studies involving 723 patients (G-GR 1800 mg, n = 359; placebo, n = 364). Patients (43% male, mean age 66 years) with PHN pain >4 (0-10 scale) for ≥3 months were enrolled. Summary statistics for the incidence of treatment-emergent adverse events (AEs) were performed. Laboratory parameters and vital signs were assessed. RESULTS:
Treatment-emergent AEs were reported in 48% of patients (G-GR, 54%; placebo, 42%) and led to discontinuation in 8% of patients (G-GR, 10%; placebo, 7%). The most frequent (≥3% in any group) AEs were dizziness (G-GR, 11%; placebo, 2%), somnolence (G-GR, 5%; placebo, 3%), headache (G-GR, 4%; placebo, 4%), peripheral edema (G-GR, 4%; placebo, <1%), and diarrhea (G-GR, 3%; placebo, 3%). Serious AEs were reported in seven patients in the G-GR group (2%) and ten patients in the placebo group (3%). There were two deaths, both in the placebo group. No serious AEs were considered related to treatment. Mean values for laboratory parameters and vital signs at the end of each study were similar between groups. CONCLUSION: G-GR was safe and well tolerated for the treatment of PHN.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3392710/pdf/jpr-5-203.pdf
Tratamiento de neuralgia postherpética: atención a pregabalina
Treatment of postherpetic neuralgia: focus on pregabalin.
Cappuzzo KA.
The Geriatric Pharmacotherapy Program, Virginia Commonwealth University, School of Pharmacy, Richmond, Virginia 23298-0533, USA.kacappuzzo@vcu.edu
Clin Interv Aging. 2009;4:17-23. Epub 2009 May 14.
Abstract
Postherpetic neuralgia (PHN) is a devastating, chronic pain syndrome that can develop following an outbreak of herpes zoster and becomes increasingly common as patients age. PHN can be difficult to treat and often requires trials of multiple agents to achieve significant pain relief. Pregabalin is the newest agent to gain approval for PHN. Data suggest efficacy for relief of pain and sleep disturbance secondary to PHN in affected patients. Although there are no head-to-head comparisons, pregabalin appears comparable to gabapentin and other first-line agents for treating PHN.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2685221/pdf/cia-4-017.pdf
Atentamente
Anestesiología y Medicina del Dolor
www.anestesia-dolor.org
Gabapentin for once-daily treatment of post-herpetic neuralgia: a review.
Beal B, Moeller-Bertram T, Schilling JM, Wallace MS.
Division of Pain Medicine, Department of Anesthesiology, University of California, San Diego, CA, USA.
Clin Interv Aging. 2012;7:249-55. Epub 2012 Jul 12.
Abstract
Post-herpetic neuralgia is a neuropathic pain syndrome resulting from an insult to the peripheral and central nervous systems caused by the varicella zoster virus. Spontaneous pain may result in the persistent sensation of burning, tingling, or aching and may be associated with thermally or mechanically provoked pain, resulting in hyperalgesia or allodynia. The majority of cases occur in patients over the age of 50 years. Gabapentin is a structural analog of gamma aminobutyric acid that binds to the α(2)-δ site of voltage-dependent calcium channels and modulates the influx of calcium, with a resulting reduction in excitatory neurotransmitter release. Gabapentin is effective in reducing neuropathic pain due to post-herpetic neuralgia when given at least three times per day, due to its short half-life, resulting in demonstrable fluctuations in plasma levels. Gabapentin has dose-limiting side effects that prevent some patients from achieving therapeutic plasma levels, such as somnolence (27.4%), dizziness (23.9%), and ataxia (7.1%). Gralise™ is a once-daily extended-release formulation of gabapentin that has been developed using AcuForm™ technology. AcuForm is a polymer-based drug delivery system that retains the tablet in the stomach and upper gastrointestinal tract for a sustained period of time. Once-daily dosing has been shown to provide comparable drug exposure with an identical daily dose of the immediate-release formulation when administered three times daily. Participants given Gralise 1800 mg daily had a statistically significant reduction in average daily pain intensity scores compared with placebo, reduced sleep interference due to pain, and a greater percent of participants reporting being much or very much improved on the patient global impression of change. An analysis comparing the efficacy and safety profiles in the aging population (≥65 years) with those younger than 65 years showed that Gralise is effective and well tolerated in both age groups.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3410680/pdf/cia-7-249.pdf
http://www.dovepress.com/gabapentin-for-once-daily-treatment-of-post-herpetic-neuralgia-a-revie-peer-reviewed-article-CIA
Tolerabilidad y seguridad de las tabletas gastroretentivas de gabapentina para dosis diaria en el manejo de la neuralgia postherpética
Tolerability and safety of gastroretentive once-daily gabapentin tablets for the treatment of postherpetic neuralgia.
Irving GA, Sweeney M.
Swedish Pain and Headache Center, Seattle, WA, USA.
J Pain Res. 2012;5:203-8. Epub 2012 Jun 25.
Abstract
OBJECTIVE: An immediate-release formulation of gabapentin is approved for treatment of postherpetic neuralgia (PHN). This formulation, however, requires multiple daily dosing, usually three times per day, and is associated with a high incidence of somnolence and dizziness. We assessed the tolerability and safety of a once-daily gastroretentive formulation of gabapentin (G-GR) in phase 3 clinical trials in patients with PHN.RESEARCH DESIGN AND METHODS: Data were pooled from two placebo-controlled studies involving 723 patients (G-GR 1800 mg, n = 359; placebo, n = 364). Patients (43% male, mean age 66 years) with PHN pain >4 (0-10 scale) for ≥3 months were enrolled. Summary statistics for the incidence of treatment-emergent adverse events (AEs) were performed. Laboratory parameters and vital signs were assessed. RESULTS:
Treatment-emergent AEs were reported in 48% of patients (G-GR, 54%; placebo, 42%) and led to discontinuation in 8% of patients (G-GR, 10%; placebo, 7%). The most frequent (≥3% in any group) AEs were dizziness (G-GR, 11%; placebo, 2%), somnolence (G-GR, 5%; placebo, 3%), headache (G-GR, 4%; placebo, 4%), peripheral edema (G-GR, 4%; placebo, <1%), and diarrhea (G-GR, 3%; placebo, 3%). Serious AEs were reported in seven patients in the G-GR group (2%) and ten patients in the placebo group (3%). There were two deaths, both in the placebo group. No serious AEs were considered related to treatment. Mean values for laboratory parameters and vital signs at the end of each study were similar between groups. CONCLUSION: G-GR was safe and well tolerated for the treatment of PHN.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3392710/pdf/jpr-5-203.pdf
Tratamiento de neuralgia postherpética: atención a pregabalina
Treatment of postherpetic neuralgia: focus on pregabalin.
Cappuzzo KA.
The Geriatric Pharmacotherapy Program, Virginia Commonwealth University, School of Pharmacy, Richmond, Virginia 23298-0533, USA.kacappuzzo@vcu.edu
Clin Interv Aging. 2009;4:17-23. Epub 2009 May 14.
Abstract
Postherpetic neuralgia (PHN) is a devastating, chronic pain syndrome that can develop following an outbreak of herpes zoster and becomes increasingly common as patients age. PHN can be difficult to treat and often requires trials of multiple agents to achieve significant pain relief. Pregabalin is the newest agent to gain approval for PHN. Data suggest efficacy for relief of pain and sleep disturbance secondary to PHN in affected patients. Although there are no head-to-head comparisons, pregabalin appears comparable to gabapentin and other first-line agents for treating PHN.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2685221/pdf/cia-4-017.pdf
Atentamente
Anestesiología y Medicina del Dolor
www.anestesia-dolor.org
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