» Articles » PMID: 35844692

Gabapentin for Acute Pain in Sickle Cell Disease: A Randomized Double-blinded Placebo-controlled Phase II Clinical Trial

Overview
Journal EJHaem
Specialty Hematology
Date 2022 Jul 18
PMID 35844692
Authors
Affiliations
Soon will be listed here.
Abstract

Pain in sickle cell disease (SCD) can have a neuropathic component. This randomized phase II double-blinded placebo-controlled study evaluated the efficacy of gabapentin in reducing pain and opioid consumption (morphine-equivalent dose [MED]) during acute vaso-occlusive crisis (VOC). Of 90 patients aged 1-18 years with VOC pain, 45 were randomized to a single gabapentin dose (15 mg/kg) and 45 to placebo, in addition to standard treatment; 42 and 44 patients were evaluable in the gabapentin and placebo arms, respectively. A decrease in pain of ≥33% was reported in 68% of patients in the gabapentin arm and 60% of those in the placebo arm (one-sided 0.23). The median MED (mg/kg) in the gabapentin (0.12) and placebo arms (0.13) was similar ( 0.9). However, in the subset of patients with the HbSS genotype ( = 45), the mean (SD) absolute pain score decrease by the time of discharge was significantly greater in the gabapentin arm (5.9 [3.5]) than in the placebo arm (3.6 [3.3]) (0.032). Pain scores in the overall study population were not significantly reduced when gabapentin was added to standard treatment; however, gabapentin benefited individuals with the more severe genotype, HbSS, during acute VOC. Larger, prospective studies are needed to confirm these findings.

Citing Articles

Patient and clinician beliefs about potential barriers to treatment of neuropathic pain for adolescents with sickle cell disease.

Rees M, Spraker-Perlman H, Moore R, Lavoie P, Schiff L, Allen J EJHaem. 2024; 5(1):11-20.

PMID: 38406507 PMC: 10887355. DOI: 10.1002/jha2.829.


Gabapentin for acute pain in sickle cell disease: A randomized double-blinded placebo-controlled phase II clinical trial.

Puri L, Nottage K, Hankins J, Wang W, McGregor O, Gossett J EJHaem. 2022; 2(3):327-334.

PMID: 35844692 PMC: 9175868. DOI: 10.1002/jha2.188.


Moving Toward a Multimodal Analgesic Regimen for Acute Sickle Cell Pain with Non-Opioid Analgesic Adjuncts: A Narrative Review.

Kenney M, Smith W J Pain Res. 2022; 15:879-894.

PMID: 35386424 PMC: 8979590. DOI: 10.2147/JPR.S343069.

References
1.
Butkovic D, Toljan S, Mihovilovic-Novak B . Experience with gabapentin for neuropathic pain in adolescents: report of five cases. Paediatr Anaesth. 2006; 16(3):325-9. DOI: 10.1111/j.1460-9592.2005.01687.x. View

2.
Brandow A, Farley R, Panepinto J . Early insights into the neurobiology of pain in sickle cell disease: A systematic review of the literature. Pediatr Blood Cancer. 2015; 62(9):1501-11. PMC: 4515148. DOI: 10.1002/pbc.25574. View

3.
Wang Z, Wilkie D, Molokie R . Neurobiological mechanisms of pain in sickle cell disease. Hematology Am Soc Hematol Educ Program. 2011; 2010:403-8. PMC: 3650026. DOI: 10.1182/asheducation-2010.1.403. View

4.
von Baeyer C . Children's self-reports of pain intensity: scale selection, limitations and interpretation. Pain Res Manag. 2006; 11(3):157-62. PMC: 2539005. DOI: 10.1155/2006/197616. View

5.
Jacob E, Chan V, Hodge C, Zeltzer L, Zurakowski D, Sethna N . Sensory and Thermal Quantitative Testing in Children With Sickle Cell Disease. J Pediatr Hematol Oncol. 2014; 37(3):185-9. PMC: 6589156. DOI: 10.1097/MPH.0000000000000214. View