Gabapentin can improve analgesia in patients receiving systemic opioids for neuropathic cancer pain, European researchers report in the June 15th issue of the Journal of Clinical Oncology.
Dr. Augusto Caraceni of the National Cancer Institute of Milan, Italy and colleagues note that there have been anecdotal reports of the efficacy of the new-generation anticonvulsant gabapentin (Neurontin) used in combination with opioid analgesics.To investigate further, the researchers conducted a double-blind study of 121 patients with neuropathic cancer pain, which was partially controlled with systemic opioids.In addition to a stable opioid dose, they were randomized to treatment with gabapentin 800 to 1800 mg per day or to placebo. Additional opioid doses were supplied as needed.Overall, 89 patients completed the 10-day study. Intent-to-treat analysis showed a significant difference in scores on a 10-point pain scale between gabapentin (4.6) and placebo (5.4).Further analysis showed a significant reduction in dysesthesia in gabapentin patients. Moreover, use of supplementary analgesic doses was higher and more frequent in placebo patients.The researchers conclude that the findings “demonstrate a limited role of gabapentin as adjuvant to opioids for neuropathic cancer pain.” Nevertheless, they add that “significant benefit could be seen in some patients.”(Source: J Clin Oncol 2004;22:2909-2917: Reuters Health: Oncolink: July 2004.)