Google
Trusted Resources: Evidence & Education
Scientific literature and patient education texts
Gabapentin for Pain in Sickle Cell Disease: Results of a Randomized Phase ll Clinical Trial
source: American Society of Pediatric Hematology/Oncology
year: N/A
summary/abstract:Background:
Pain in sickle cell disease (SCD) can have a significant neuropathic component. Therapies targeting neuropathic pain have not been extensively studied in this setting. We report results of a randomized controlled trial evaluating utility of gabapentin for acute vaso-occlusive crisis (VOC) pain.
Objectives:
The primary objective was to evaluate efficacy of gabapentin when added to standard therapy for acute VOC pain. Main outcome was as >33% reduction in pain scores between presentation (baseline) and assessment at 3 hours post-study drug administration. The secondary objective was to compare opioid consumption as morphine equivalent dose (MED, mg/kg) between baseline and 3 hours, in the gabapentin versus placebo groups.
Design/Method:
This was a phase II double-blind placebo-controlled study. Patients with SCD, ages 1 to 21 years, presenting with VOC pain were enrolled and randomized to receive either a single oral dose of gabapentin, 15 mg/kg or placebo in addition to standard treatment. Pain scores and opioid requirement were compared between treatment arms.
Results:
Ninety patients (35 females, 59 males) were randomized, 45 in each arm. Forty-two and forty-four participants were evaluable in gabapentin and placebo arms, respectively. Pain scores at presentation were similar for both groups, mean (standard deviation/SD) 7.8 (1.8). In gabapentin arm, 67.5% (n=27) patients experienced >33% decrease in pain from presentation to 3 hours post treatment versus 59.5% (n=25) in placebo arm (p=0.23, Z-test). The overall mean (SD) MED (mg/kg) was 0.16 (0.10), with no significant difference between gabapentin (median 0.12, SD: 0.09) and placebo arms (median 0.13, SD: 0.11) (p = 0.897, Wilcoxon rank sum test). Absolute decrease in pain scores from baseline to admission or discharge from acute care was higher in gabapentin (median 1.0, SD: 3.1) as compared to placebo arm (median 0.5, SD: 2.3), but not significant (p=0.38, Wilcoxon rank sum test). However, for patients with HbSS genotype absolute pain decrease was significantly greater in gabapentin (mean 5.9, SD: 3.5) versus placebo arm (mean 3.6, SD: 3.3) (p = 0.03, t-test).
Conclusion:
Although not significant, a greater proportion of patients achieved clinical improvement in pain when gabapentin was added to standard therapy. Gabapentin also resulted in greater decrease in pain scores, particularly in patients with HbSS. Thus, gabapentin can be a useful adjunct to standard management, particularly for patients with HbSS, who generally have a more severe phenotype and often with neuropathic pain features. Future studies with larger cohorts are needed to confirm these findings.
read more
+myBinderRelated Content
-
Sustainability of Hematological and Clinical Benefits to HU Administration in the Prevention of Sickle-Cell Vaso-Occ...Hydroxyurea (HU) is approved in EU and U...
-
Comparing Sickle Cell Disease Acute Pain Management in the Pediatric and Adult Emergency DepartmentBackground: Vasoocclusive pain leading ...
-
APS Scientific Meeting 2019The American Pain Society will hold its ...
-
GBT expands sickle cell disease pipeline with worldwide licensing agreement for inclacumab for the treatment of vaso...Global Blood Therapeutics, Inc...
-
SCD Patients Benefit From Early Rivipansel Treatment for VOCs, New Analyses ShowStarting treatment with rivipansel (GMI-...
-
How sickled red blood cells stick to blood vesselsOne of the most common complications o...
-
CTX001 Continues to Show Promise in Severe SCDA single dose of CTX001, an experimental...
To improve your experience on this site, we use cookies. This includes cookies essential for the basic functioning of our website, cookies for analytics purposes, and cookies enabling us to personalize site content. By clicking on 'Accept' or any content on this site, you agree that cookies can be placed. You may adjust your browser's cookie settings to suit your preferences. More Information
The cookie settings on this website are set to "allow cookies" to give you the best browsing experience possible. If you continue to use this website without changing your cookie settings or you click "Accept" below then you are consenting to this.
Powered by
Support for this site is provided by
This platform is made possible through a partnership with the Sickle Cell Disease Association of America, Inc. (SCDAA) and its member organizations. SCDAA's mission is to advocate for people affected by sickle cell conditions and empower community-based organizations to maximize quality of life and raise public consciousness while advancing the search for a universal cure.