Pregabalin shows benefit against postmastectomy pain syndrome in Egyptian RCT

  • Reyad RM & al.
  • J Pain Symptom Manage
  • 22 Oct 2018

  • curated by Miriam Davis, PhD
  • Univadis Clinical Summaries
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Takeaway

  • Pregabalin given at the time of mastectomy to 7 postoperative days cuts the development of postmastectomy pain syndrome (PMPS) by 74% vs placebo.

Why this matters

  • PMPS is a neuropathic pain condition that affects 10% to 40% of patients and negatively affects QoL.

Study design

  • Randomized, double-blind, placebo-controlled clinical trial of pregabalin (n=100) or placebo (n=100) given as 75 mg twice daily from the time of induction of anesthesia to postoperative day 7 in patients with breast cancer undergoing mastectomy.
  • The primary outcome was rate of PMPS diagnosis at 12 weeks, with PMPS diagnosed by clinical criteria (neuropathic pain involving the anterior aspect of the chest, axilla, and/or upper arm that persists continuously or intermittently for ≥3 months).
  • Funding: None disclosed.

Key results

  • The pregabalin group (vs placebo) had less frequent neuropathic pain (Grading System for Neuropathic Pain, ≥grade 3) at 4 weeks (P=.005), 12 weeks (P=.002), and 24 weeks (P<.001>
  • The pregabalin group had lower pain scores (by visual analog scale) at 4 weeks (P=.001), 12 weeks (P=.007), and 24 weeks (P=.002).
  • The pregabalin group had 74% lower risk for PMPS at 12 weeks (11% vs 29%; relative risk, 0.26; P<.001>
  • No difference between groups in rate of adverse events.

Limitations

  • Single-center study.

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