Milnacipran神经性疼痛与纤维肌痛的成年人。

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菲利普斯德里年代,吉尔D, T,摩尔RA

Milnacipran神经性疼痛与纤维肌痛的成年人。

科克伦数据库系统启2012 3月14;(3):CD008244。cd008244.pub2 doi: 10.1002/14651858.。

PubMed ID
22419330 (在PubMed
]
文摘

背景:Milnacipran serotonin-norepinephrine再摄取抑制剂(去甲肾上腺素重摄取抑制剂),有时被用来治疗慢性神经性疼痛和纤维肌痛。目的:评估milnacipran的镇痛疗效和不良反应管理慢性神经性疼痛或纤维肌痛。搜索方法:我们搜查了中央、MEDLINE和EMBASE 2012年1月4日,一起参考列表检索论文和评论。选择标准:我们包括随机,双盲的研究八周时间甚至更长,与安慰剂比较milnacipran或另一个积极治疗慢性神经性疼痛或纤维肌痛。数据收集和分析:我们提取的疗效和不良事件数据,和两个独立研究的作者检查学习素质的问题。主要结果:五个研究参与者(4138)包括在内,所有的安慰剂对照,与纤维肌痛涉及参与者,用滴定目标剂量100毫克和200毫克milnacipran。没有其他活动比较器或研究其他神经性疼痛的条件。研究质量普遍很好,虽然归责方法用于分析的主要结果可能高估了治疗效果。两种剂量的milnacipran提供适度的缓解疼痛,约40%的治疗,30%与安慰剂相比,给很多需要治疗的8到10。beplayapp不良事件在两milnacipran很常见(87%),安慰剂组(78%),但严重不良事件(< 2%)组没有差异。 Nausea and constipation were the most common events showing the greatest difference between groups (number needed to treat for an additional harmful outcome of 7 and 13 respectively, compared with placebo).Withdrawals for any reason were more common with milnacipran than placebo, and more common with 200 mg than 100 mg (NNH of 23 and 8.8 respectively, compared with placebo). This was largely driven by adverse event withdrawals, where the NNH compared with placebo was 14 for 100 mg, and 7.0 for 200 mg). Withdrawals due to lack of efficacy were more common with milnacipran than placebo but did not differ between doses (number needed to treat to prevent an additional unwanted outcome of 45 and 41 respectively). AUTHORS' CONCLUSIONS: The evidence available indicates that milnacipran 100 mg or 200 mg is effective for a minority in the treatment of pain due to fibromyalgia, providing moderate levels of pain relief (at least 30%) to about 40% of participants, compared with about 30% with placebo. There were insufficient data to assess substantial levels of pain relief (at least 50%), and the use of last observation carried forward imputation may overestimate drug efficacy. Milnacipran is associated with increased adverse events and adverse event withdrawals, which were significantly greater for the higher dose. There were no data for the use of milnacipran for other chronic neuropathic pain conditions.

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