Gabapentin for Acute Pain in Sickle Cell Disease: A Randomized Double-blinded Placebo-controlled Phase II Clinical Trial
Overview
Authors
Affiliations
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.
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.
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.
Kenney M, Smith W J Pain Res. 2022; 15:879-894.
PMID: 35386424 PMC: 8979590. DOI: 10.2147/JPR.S343069.