Gabapentin, Pregabalin Effective for Burn-Related Pruritus, Neuropathic Pain

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Patients with burns were treated with pregabalin or gabapentin for the management of pruritus and/or neuropathic pain.
Patients with burns were treated with pregabalin or gabapentin for the management of pruritus and/or neuropathic pain.

The use of gabapentin, pregabalin, or both is effective for reducing pruritus and neuropathic pain in burn survivors, according to the findings from a small retrospective review published in Burns.1

In this study, researchers examined charts and pharmacy records of burn survivors up to age 20 who were treated with pregabalin or gabapentin for the management of pruritus and/or neuropathic pain. Of the 136 patients assessed, 112 received gabapentin and 24 received both pregabalin and gabapentin. The Itch Assessment Scale was used to rate pruritus severity.

The average effective doses of gabapentin for patients age <5, 6-12, and >12 were 23.9±10.3mg/kg/day, 27.0±15.3mg/kg/day, and 34.1±15.7mg/kg/day, respectively. For pregabalin, the average effective dose was 6.5±3.5mg/kg/day for age 6-12 and 4.7±1.6mg/kg/day for >12.

Patients treated with gabapentin only for pruritus had a 91.4% adequate response rate. In addition, using only gabapentin resulted in a 100% response rate for neuropathic pain and a 43.3% response rate for both pruritus and pain. The combination of both gabapentin and pregabalin resulted in a 100% adequate response rate for pruritus and 88.2% response rate for pruritus and pain.

Investigators commented that the time needed for treatment may vary from individual to individual, and that “the duration of treatment could differ based on the total burn surface area or other factors.”

Study Limitations

The children in this study could not discriminate between pain and pruritus, and many children reported extremes when rating their pruritus. Thus, the subjective nature of this study may have led to unreliable results. The investigators commented that a larger study size with randomization to either pregabalin or gabapentin could add greater validity to their findings.

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Reference

  1. Kaul I, Amin A, Rosenberg M, et al. Use of gabapentin and pregabalin for pruritus and neuropathic pain associated with major burn injury: A retrospective chart review. [published online August 16, 2017]. Burns. doi:10.1016/j.burns.2017.07.018
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