米罗巴林治疗神经性疼痛和相关睡眠干扰:一项最新的荟萃分析。

IF 3.4 2区 医学 Q1 ANESTHESIOLOGY
Rafael Batista João, Jilly Octoria Tagore Chan, André Batista João, Luísa Mendes Araújo, Julyana Medeiros Dantas
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引用次数: 0

摘要

背景和目的:神经性疼痛(NeP)是几种神经系统疾病的常见和衰弱性后果。加巴喷丁类药物被大量用于治疗中央和外周性NeP。米罗巴林是一种新型加巴喷丁类药物,被认为是治疗这种疾病的一种很有希望的药物;然而,其有效性和安全性仍需在临床实践中进一步确定。在这篇系统综述和荟萃分析中,我们评估了在NeP患者中,与安慰剂相比,米罗巴林对疼痛强度降低的疗效、对疼痛干扰睡眠的影响以及安全性。数据库和数据处理:我们检索PubMed、Cochrane Library、Embase、Web of Science和ClinicalTrials.gov数据库,查找比较米罗巴林和安慰剂在中枢性或外周性NeP患者中的随机对照试验(rct)。我们分别计算了连续结局和二元结局的平均差异(MD)和合并风险比(RR),置信区间为95%。疼痛以0到10的数值评定量表进行测量。结果:我们纳入6项随机对照试验,涉及3048例患者。平均年龄60.6岁,男性占64.7%。与安慰剂相比,接受米罗巴林治疗的患者平均每日疼痛显著降低(MD -0.60; 95% CI -0.75至-0.45;p)结论:在评估中枢性和外周性NeP患者的rct荟萃分析中,与安慰剂相比,米罗巴林显著改善了疼痛,减少了疼痛对睡眠的干扰;然而,不良事件的风险增加。意义:这项荟萃分析通过展示在神经性疼痛综合征中减轻疼痛和疼痛相关睡眠干扰方面适度但一致的益处,完善了目前对米罗巴林的理解。结果有助于持续努力优化神经性疼痛管理,并为临床决策和指南制定提供更有力的证据。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Mirogabalin for Treatment of Neuropathic Pain and Associated Sleep Interference: An Updated Meta-Analysis

Mirogabalin for Treatment of Neuropathic Pain and Associated Sleep Interference: An Updated Meta-Analysis

Background and Objective

Neuropathic pain (NeP) is a common and debilitating consequence of several neurological conditions. Gabapentinoids are used on a large scale for the treatment of both central and peripheral NeP. Mirogabalin, a novel gabapentinoid, has been proposed as a promising treatment for this condition; however, its efficacy and safety profile still need to be determined in clinical practice. In this systematic review and meta-analysis, we assessed the efficacy on pain intensity reduction, effects on sleep interference by pain, and safety of mirogabalin compared with placebo in patients affected by NeP.

Databases and Data Treatment

We searched PubMed, Cochrane Library, Embase, Web of Science, and ClinicalTrials.gov databases for randomised controlled trials (RCTs) comparing mirogabalin with placebo in patients experiencing central or peripheral NeP. We computed mean differences (MD) and pooled risk ratios (RR) for continuous and binary outcomes, respectively, with 95% confidence intervals (CI). Pain was measured on a 0 to 10 numerical rating scale.

Results

We included 6 RCTs involving 3048 patients. The mean age was 60.6 years, and 64.7% were male. When compared with placebo, patients treated with mirogabalin had a significant decrease in average daily pain (MD −0.60; 95% CI −0.75 to −0.45; p < 0.001) and in pain-related sleep interference scores (MD −0.66; 95% CI −0.81 to −0.51; p < 0.001). The mirogabalin group showed a higher rate of substantial pain relief (≥ 50%) compared with the placebo group (RR 1.27; 95% CI 1.10 to 1.46; p = 0.001). Nonetheless, treatment with mirogabalin increased the risk of weight gain, peripheral oedema, somnolence and dizziness.

Conclusion

In this meta-analysis of RCTs evaluating patients with central and peripheral NeP, mirogabalin significantly improved pain and decreased sleep interference by pain, as compared with placebo; however, there was an increased risk of adverse events.

Significance

This meta-analysis refines the current understanding of mirogabalin by demonstrating modest yet consistent benefits in reducing pain and pain-related sleep interference across neuropathic pain syndromes. The results contribute to ongoing efforts to optimise neuropathic pain management and provide more robust evidence to support clinical decision-making and guideline development.

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来源期刊
European Journal of Pain
European Journal of Pain 医学-临床神经学
CiteScore
7.50
自引率
5.60%
发文量
163
审稿时长
4-8 weeks
期刊介绍: European Journal of Pain (EJP) publishes clinical and basic science research papers relevant to all aspects of pain and its management, including specialties such as anaesthesia, dentistry, neurology and neurosurgery, orthopaedics, palliative care, pharmacology, physiology, psychiatry, psychology and rehabilitation; socio-economic aspects of pain are also covered. Regular sections in the journal are as follows: • Editorials and Commentaries • Position Papers and Guidelines • Reviews • Original Articles • Letters • Bookshelf The journal particularly welcomes clinical trials, which are published on an occasional basis. Research articles are published under the following subject headings: • Neurobiology • Neurology • Experimental Pharmacology • Clinical Pharmacology • Psychology • Behavioural Therapy • Epidemiology • Cancer Pain • Acute Pain • Clinical Trials.
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