EFFICACY AND SAFETY OF GABAPENTIN AND PREGABALIN IN CHEMOTHERAPY-INDUCED PERIPHERAL NEUROPATHY

MANJUSHREE N; ANANYA CHAKRABORTY; SHASHIDHAR V

doi:10.22159/ajpcr.2021.v14i1.39978

Authors

MANJUSHREE N Department of Pharmacology, Vydehi Institute of Medical Sciences and Research Centre, Whitefield, Bengaluru, India.
ANANYA CHAKRABORTY Department of Pharmacology, Vydehi Institute of Medical Sciences and Research Centre, Whitefield, Bengaluru, India.
SHASHIDHAR V Department of Oncology, Vydehi Institute of Medical Sciences and Research Centre, Whitefield, Bengaluru, India.

DOI:

https://doi.org/10.22159/ajpcr.2021.v14i1.39978

Keywords:

Chemotherapy-induced neuropathic pain, Chemotherapy-induced peripheral neuropathy, Gabapentin, Pregabalin

Abstract

Objectives: Chemotherapy-Induced Peripheral Neuropathy (CIPN) occurs as a common Adverse Drug Reaction (ADR) of anti-cancer drugs. The prevalence varies from 10% to 100%. To date, there is no standard effective treatment protocol for this condition. However, the neuro-modulators such as gabapentin and pregabalin are increasingly being used to treat CIPN. With this background this study was undertaken to compare the efficacy and safety of gabapentin and pregabalin in CIPN.

Methods: This study was conducted in the department of medical oncology at Vydehi Institute of Medical Sciences and Research Centre, Bengaluru. It was initiated after the approval from Institutional Ethics Committee. After obtaining written informed consent, the participants were randomized into two groups. Group A received gabapentin, 300 mg orally and Group B received pregabalin 75 mg orally; twice daily for 8 weeks. They were followed up at 2, 4, and 8 weeks. The intensity and quality of pain were assessed by visual analog scale (VAS) and pain quality assessment scale (PQAS). Safety was assessed by reported ADR. Data were analyzed using Student’s t-test and Mann–Whitney U-test. p=0.05 or less was considered as statistically significant.

Results: Reduction in VAS and PQAS scores at 8 weeks was statistically significant in each group (p<0.0001). The ADR common to both the groups was drowsiness and sedation. The prevalence of ADR was more in the gabapentin group.

Conclusion: Both gabapentin and pregabalin have similar clinical efficacy in the treatment of CIPN. The prevalence of ADR was higher in gabapentin group compared to pregabalin group.

Downloads

Download data is not yet available.

References

Overview: National Cancer Control Programme, India. Available from: https://www.who.int/cancer/modules/India.pdf?ua=1. [Last accessed on 2018 Dec 16].

Lesage P, Portenoy RK. Trends in cancer pain management. Cancer Control 1999;6:136-45.

Trivedi MS, Hershman DL, Crew KD. Management of chemotherapy-induced peripheral neuropathy. Am J Hematol Oncol 2015;2:4-10.

Banerjee M, Pal S, Bhattacharya B, Ghosh B, Mondal S, Basu B. A comparative study of efficacy and safety of gabapentin versus amitriptyline as coanalgesics in patients receiving opioid analgesics for neuropathic pain in malignancy. Indian J Pharmacol 2013;45:334-8.

Keskinbora K, Pekel AF, Aydinli I. Gabapentin and an opioid combination versus opioid alone for the management of neuropathic cancer pain: A randomized open trial. J Pain Symptom Manag 2007;34:183-9.

Toth C. Substitution of gabapentin therapy with pregabalin therapy in neuropathic pain due to peripheral neuropathy. Pain Med 2010;11:456-65.

Honarmand A, Safavi M, Zare M. Gabapentin: An update of its pharmacological properties and therapeutic use in epilepsy. J Res Med Sci 2011;16:1062-9.

Bockbrader HN, Wesche D, Miller R, Chapel S, Janiczek N, Burger P. A comparison of the pharmacokinetics and pharmacodynamics of pregabalin and gabapentin. Clin Pharmacokinet 2010;49:661-9.

Ghosh AK, Kundu A, Das AP, Bhattacharya KB. Comparative study of efficacy and safety of pregabalin and gabapentin in neuropathic pain. Asian J Pharm Life Sci 2012;2:64-71.

Argyriou AA, Kyritsis AP, Makatsoris T, Kalofonos HP. Chemotherapy-induced peripheral neuropathy in adults: A comprehensive update of the literature. Cancer Manag Res 2014;6:135-47.

Moulin DE, Boulanger MD, Williamson OD. Pharmacological management of chronic neuropathic pain: Revised consensus statement from the Canadian pain society. Pain Res Manag 2014;19:328-35.

Devi P, Madhu K, Kulkarni C. Evaluation of efficacy and safety of gabapentin, duloxetine, and pregabalin in patients with painful diabetic peripheral neuropathy. Indian J Pharmacol 2012;44:51-6.

Kaydok E, Levendoglu F, Ozerbil MO, Karahan AY. Comparison of the efficacy of gabapentin and pregabalin for neuropathic pain in patients with spinal cord injury: A crossover study. Acta Med Mediterr 2014;30:1343-8.

Ghai A, Gupta M, Hooda S, Singla D, Wadhera R. A randomized controlled trial to compare pregabalin with gabapentin for postoperative pain in abdominal hysterectomy. Saudi J Anaesth 2011;5:252-7.