Gabapentenoids in pain management in urological chronic pelvic pain syndrome: Gabapentin or pregabalin?

摘要

AIMS To compare efficacy of gabapentin and pregabalin in patients with urological chronic pelvic‐pain syndrome (UCPPS). METHODS Design—retrospective, setting—urology outpatient services of a secondary‐care private hospital, inclusion criteria—men 18‐50 years, presenting with pelvic pain (lower abdomen, groin, scrotum, perineum, low‐back, hip) with or without lower urinary tract symptoms for at least 3 months duration. Hospital database was searched using keywords for neuropathic pain (ICD9—729.2, 719.45) and prostatitis (ICD9—601.1, 601.9). Clinical data were retrieved from patient‐records, laboratory and radiology data, and analyzed using SPSS‐19 statistical software. RESULTS Between Mar 2013 and Oct 2015, data of consecutive 119 patients fulfilling the above criteria was analyzed. Median age of patients was 35 years (IQR 29‐43) and median duration of symptoms 12 months (IQR 6‐24 months). Before treatment median VAS (0‐10) pain score was 5 (IQR 4‐6). Gabapentin was significantly more effective in controlling pain compared to pregabalin. Three fourth of patients on gabapentin alone (47/62) reported at least 50% improvement in pain compared to only 40% on pregabalin alone (12/30) ( P? =?0.0012; χ 2 ?=?9.765. NNT 2.9, 95%CI 1.8‐6.5). Twenty patients who were initially put on pregabalin had to switch to gabapentin for lack of efficacy. Forty four percent of patients on pregabalin required amitriptyline (24/54) compared to only 13.6% of those on gabapentin (10/72) required the same ( P value of difference 0.0001; χ 2 ?=?14.622. NNT 4, CI 95% 2.2‐6.6). CONCLUSIONS Gabapentin may be more effective than pregabalin in UCPPS.