Effect of Gabapentin vs Pregabalin on Pain Intensity in Adults With Chronic Sciatica

作者：Kelvin Robertson, Laurence A.G. Marshman, David Plummer, Elena Downs · 发表于：JAMA Neurology · 年份：2018 · DOI：10.1001/jamaneurol.2018.3077 · 被引用次数：84 · 研究领域：Spine and Intervertebral Disc Pathology、Cervical and Thoracic Myelopathy、Botulinum Toxin and Related Neurological Disorders

Importance: Optimal pharmacologic treatment for chronic sciatica (CS) is currently unclear. While gabapentin (GBP) and pregabalin (PGB) are both used to treat CS, equipoise exists. Nevertheless, pharmaceutical regulation authorities typically subsidize one drug over the other. This hinders interchange wherever the favored drug is either ineffective or ill-tolerated. Objective: To assess GBP vs PGB head to head for the treatment of CS. Design, Setting, and Participants: A preplanned interim analysis of a randomized, double-blind, double-dummy crossover trial of PGB vs GBP for management of CS at half the estimated final sample size was performed in a single-center, tertiary referral public hospital. A total of 20 patients underwent randomization from March 2016 to March 2018, and 2 were excluded with 1 lost to follow-up and the other requiring urgent surgery unrelated to the study. Patients attending a specialist neurosurgery clinic with unilateral CS were considered for trial recruitment. Chronic sciatica was defined as pain lasting for at least 3 months radiating into 1 leg only to, at, or below the knee level. Imaging (magnetic resonance imaging with or without computed tomography) corroborating a root-level lesion concordant with symptoms and/or signs was determined by the trial clinician. Inclusion criteria included patients who had not used GBP and PGB and were 18 years or older. Analyses were intention to treat and began February 2018. Interventions: Randomly assigned p...