Abstract
Objective
To assess the efficacy and safety of gabapentin in patients with fibromyalgia.
Methods
A 12โweek, randomized, doubleโblind study was designed to compare gabapentin (1,200โ2,400 mg/day) (n = 75 patients) with placebo (n = 75 patients) for efficacy and safety in treating pain associated with fibromyalgia. The primary outcome measure was the Brief Pain Inventory (BPI) average pain severity score (range 0โ10, where 0 = no pain and 10 = pain as bad as you can imagine). Response to treatment was defined as a reduction of โฅ30% in this score. The primary analysis of efficacy for continuous variables was a longitudinal analysis of the intentโtoโtreat sample, with treatmentโbyโtime interaction as the measure of effect.
Results
Gabapentinโtreated patients displayed a significantly greater improvement in the BPI average pain severity score (P = 0.015; estimated difference between groups at week 12 = โ0.92 [95% confidence interval โ1.75, โ0.71]). A significantly greater proportion of gabapentinโtreated patients compared with placeboโtreated patients achieved response at end point (51% versus 31%; P = 0.014). Gabapentin compared with placebo also significantly improved the BPI average pain interference score, the Fibromyalgia Impact Questionnaire total score, the Clinical Global Impression of Severity, the Patient Global Impression of Improvement, the Medical Outcomes Study (MOS) Sleep Problems Index, and the MOS Short Form 36 vitality score, but not the mean tender point pain threshold or the Montgomery Asberg Depression Rating Scale. Gabapentin was generally well tolerated.
Conclusion
Gabapentin (1,200โ2,400 mg/day) is safe and efficacious for the treatment of pain and other symptoms associated with fibromyalgia.