HIV associated peripheral neuropathy affects greater than 30% of patients with HIV/AIDS. Pregabalin (Lyrica®) has proven effective in treating neuropathic pain associated with diabetic peripheral neuropathy and post herpetic neuralgia but has previously not been studied for the treatment of HIV neuropathic pain syndrome.
At the 17th International AIDS Conference in Mexico City Thursday, David Simpson of New York City presented results from a randomized, double-blind, placebo-controlled trial to evaluate the efficacy and safety of pregabalin (Lyrica®) in the treatment of pain associated with HIV neuropathy. The study, conducted in 151 patients randomized to either pregabalin or placebo, used an endpoint mean pain score (MPS) and a secondary measure of Patient Global Impression of Change (PGIC).
Although at weeks one and two pregabalin had shown a statistically greater reduction in MPS compared with placebo, at the conclusion of the study both pregabalin and placebo groups showed similarly high reduction in MPS scores (42% vs 40%).
Pregabalin use was associated with higher rates of somnolence and dizziness compared with placebo however discontinuation rates were similar for both pregabalin and placebo (21% vs. 19%). Of interest, the reduction of 40% in the neuropathic pain was similar to that seen in previous studies of pregabalin use in diabetic peripheral neuropathy and post herpetic neuralgia, however an unexpectedly high level of MPS score reduction in the placebo arm resulted in a failure to demonstrate efficacy of pregabalin.
Reference:
Simpson D, et al. A randomized, double-blind, placebo-controlled, multicenter trial of pregabalin vs placebo in the treatment of neuropathic pain associated with HIV neuropathy. Presented at: 17th International AIDS Conference; August 3-8, 2008; Mexico City, Mexico. Abstract THAB0301.
08/07/08
Pregabalin Fails to Show Efficacy in Treatment of Neuropathic Pain Associated with HIV Neuropathy
Source: Reporting from Mexico City for PRN News: Anita Radix, MD, MPH and Rona Vail, MD