CINCINNATI, June 13 -- For treating the chronic pain and other symptoms of fibromyalgia, the anticonvulsant gabapentin (Neurontin) proved safe and effective, researchers here reported.
The entire article can be found at: http://www.cfs-info....d=621&Itemid=39
Gabapentin (Neurontin) Eases Chronic Pain in Fibro
Started By
Barbara.mj
, giu 14 2007 13:53
6 risposte a questa discussione
#2
danis
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Grande amico del forum
Inviato 14 giugno 2007 - 14:06:29
CINCINNATI, June 13 -- For treating the chronic pain and other symptoms of fibromyalgia, the anticonvulsant gabapentin (Neurontin) proved safe and effective, researchers here reported.
The entire article can be found at: http://www.cfs-info....d=621&Itemid=39
You are a gold mine, Barbara!
Thanks so much
"La mente è come un paracadute, funziona solo se si apre" A. Einstein
"tu cerchi la risposta, ma non devi cercare fuori la risposta, la risposta è dentro di te, e però è sbagliata!" Quelo
"tu cerchi la risposta, ma non devi cercare fuori la risposta, la risposta è dentro di te, e però è sbagliata!" Quelo
#3
Barbara.mj
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Inviato 14 giugno 2007 - 17:55:13
I'm so happy to be able to help! Thank you so much for the translations.
Messaggio modificato da Barbara, 14 giugno 2007 - 17:56:01
#4
romy
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Inviato 15 giugno 2007 - 00:29:29
Sarebbe interessantissima questa traduzione.
Gabapentin (Neurontin) Eases Chronic Pain in Fibromyalgia
Written by Barbara - Admin
Thursday, 14 June 2007
By Judith Groch, Senior Writer, MedPage Today
Reviewed by Robert Jasmer, MD; Associate Clinical Professor of Medicine, University of California, San Francisco
June 13, 2007
MedPage Today Action Points
Explain to interested patients that gabapentin, taken for up to 12 weeks, appeared effective and safe in reducing chronic pain, fatigue, and insomnia in fibromyalgia, but that because the study was relatively short and small, larger and longer studies are needed.
Explain to patients who ask that gabapentin is FDA approved as an anticonvulsant medication, and was used off-label for fibromyalgia.
Review
CINCINNATI, June 13 -- For treating the chronic pain and other symptoms of fibromyalgia, the anticonvulsant gabapentin (Neurontin) proved safe and effective, researchers here reported.
In a 12-week randomized, double-blind clinical trial, patients taking gabapentin displayed significantly less pain, better sleep, and less fatigue than placebo controls, Lesley M. Arnold, M.D., of the University of Cincinnati, and colleagues reported in the April issue of Arthritis and Rheumatism.
However, the drug had no effect on acute pain points or depression, the researchers reported.
Although gabapentin, which was used off-label for fibromyalgia, has little, if any, effect on acute pain, it has shown a robust effect on pain caused by a heightened response to stimuli related to inflammation or nerve injury in animal models of chronic pain syndromes, Dr. Arnold said.
Studies have also found the drug to have a substantial analgesic effects on diabetic neuropathy, postherpetic neuralgia, migraine, and other neuropathic pain conditions, as well as beneficial effects on sleep and restless legs syndrome. On the basis of these findings, the researchers suspected that gabapentin might also ease fibromyalgia pain.
The study, supported by the National Institute of Arthritis and Musculoskeletal and Skin Diseases, included 150 mainly white fibromyalgia patients (90% women). Of these, 75 took gabapentin at dosages of 1,200 to 2,400 mg daily for 12 weeks, while there were 75 placebo controls.
The study was conducted at three outpatient research centers in the U.S., from September 2003 to January 2006.
The mean pain severity scores, measured by the Brief Pain Inventory (BPI), decreased in both groups but more so among the gabapentin patients (P = 0.015). The estimated difference between groups at week 12 was - 0.92 (95% confidence interval -1.75, -0.71).
Of the gabapentin-treated patients, 51% achieved a response at the endpoint compared with 31% of the placebo patients (P= 0.014).
Gabapentin compared with placebo also significantly improved the BPI average pain interference score, as well as a series of other scores. These included the Fibromyalgia Impact Questionnaire total score, the Clinical Global Impression of Severity Improvement, the Patient Global Impression of Improvement, the Medical Outcomes Study (MOS), the Sleep Problems Index, and the MOS Short Form 36 vitality score.
However, the drug had no effect on acute pressure-point pain or depression (the Montgomery Asberg Depression Rating Scale), the researchers reported.
Overall, the drug was well-tolerated. Of the 150 patients, 19 dropped out due to adverse events, with no significant difference between the treatment groups.
The gabapentin patients reported dizziness, sedation, lightheadedness, and weight gain significantly more often that did the placebo-treated patients. Notably, the researchers said, there was no significant difference in weight change in the two groups as measured in the clinic, although edema may have explained some of the patients' perceptions. Most treatment adverse events, they reported, were mild to moderate in severity.
The pathophysiology of fibromyagia is unknown, but evidence suggests that it is associated with aberrant central nervous system pain processing, the researchers said.
The drug appears to be effective in reducing abnormal hypersensitivity induced by inflammatory responses or nerve injury. Yet unlike many other pain syndromes, there is no physical evidence of inflammation or CNS damage.
One possible explanation, Dr. Arnold said, is that gabapentin's effects involve binding to a specific subunit of voltage-gated calcium channels on neurons. This binding, she said, reduces calcium flow into the nerve cell, which reduces the release of some signaling molecules involved in pain processing.
In discussing the study's limitations, the researchers said that because the study was short, the results may not generalize to longer treatment periods, and long-term efficacy should be studied in future clinical trials.
Also, because the study was relatively small, they said it may have lacked the power to detect potentially relevant differences between the groups. Finally, they wrote that the results may not apply to patients with some comorbid psychiatric disorders, such as bipolar disorder, or to patients with other painful musculoskeletal disorders.
"In this, the first randomized, placebo-controlled study to evaluate gabapentin in the treatment of fibromyalgia, the results demonstrated that gabapentin, taken for up to 12 weeks, is effective and safe in the treatment of pain and other symptoms associated with fibromyalgia," Dr. Arnold concluded.
Primary source: Arthritis and Rheumatism
Source reference:
Arnold LM, et al "Gabapentin in the Treatment of Fibromyalgia: A Randomized, Double-Blind, Placebo-Controlled, Multicenter Trial" Arthritis Rheum 2007; 56: 1336-1344.
--------------------------------------------------------------------------------
Disclaimer
The information presented in this activity is that of the authors and does not necessarily represent the views of the University of Pennsylvania School of Medicine, MedPage Today, and the commercial supporter. Specific medicines discussed in this activity may not yet be approved by the FDA for the use as indicated by the writer or reviewer. Before prescribing any medication, we advise you to review the complete prescribing information, including indications, contraindications, warnings, precautions, and adverse effects. Specific patient care decisions are the responsibility of the healthcare professional caring for the patient. Please review our Terms of Use.
http://www.medpageto...thritis/tb/5930
Gabapentin (Neurontin) Eases Chronic Pain in Fibromyalgia
Written by Barbara - Admin
Thursday, 14 June 2007
By Judith Groch, Senior Writer, MedPage Today
Reviewed by Robert Jasmer, MD; Associate Clinical Professor of Medicine, University of California, San Francisco
June 13, 2007
MedPage Today Action Points
Explain to interested patients that gabapentin, taken for up to 12 weeks, appeared effective and safe in reducing chronic pain, fatigue, and insomnia in fibromyalgia, but that because the study was relatively short and small, larger and longer studies are needed.
Explain to patients who ask that gabapentin is FDA approved as an anticonvulsant medication, and was used off-label for fibromyalgia.
Review
CINCINNATI, June 13 -- For treating the chronic pain and other symptoms of fibromyalgia, the anticonvulsant gabapentin (Neurontin) proved safe and effective, researchers here reported.
In a 12-week randomized, double-blind clinical trial, patients taking gabapentin displayed significantly less pain, better sleep, and less fatigue than placebo controls, Lesley M. Arnold, M.D., of the University of Cincinnati, and colleagues reported in the April issue of Arthritis and Rheumatism.
However, the drug had no effect on acute pain points or depression, the researchers reported.
Although gabapentin, which was used off-label for fibromyalgia, has little, if any, effect on acute pain, it has shown a robust effect on pain caused by a heightened response to stimuli related to inflammation or nerve injury in animal models of chronic pain syndromes, Dr. Arnold said.
Studies have also found the drug to have a substantial analgesic effects on diabetic neuropathy, postherpetic neuralgia, migraine, and other neuropathic pain conditions, as well as beneficial effects on sleep and restless legs syndrome. On the basis of these findings, the researchers suspected that gabapentin might also ease fibromyalgia pain.
The study, supported by the National Institute of Arthritis and Musculoskeletal and Skin Diseases, included 150 mainly white fibromyalgia patients (90% women). Of these, 75 took gabapentin at dosages of 1,200 to 2,400 mg daily for 12 weeks, while there were 75 placebo controls.
The study was conducted at three outpatient research centers in the U.S., from September 2003 to January 2006.
The mean pain severity scores, measured by the Brief Pain Inventory (BPI), decreased in both groups but more so among the gabapentin patients (P = 0.015). The estimated difference between groups at week 12 was - 0.92 (95% confidence interval -1.75, -0.71).
Of the gabapentin-treated patients, 51% achieved a response at the endpoint compared with 31% of the placebo patients (P= 0.014).
Gabapentin compared with placebo also significantly improved the BPI average pain interference score, as well as a series of other scores. These included the Fibromyalgia Impact Questionnaire total score, the Clinical Global Impression of Severity Improvement, the Patient Global Impression of Improvement, the Medical Outcomes Study (MOS), the Sleep Problems Index, and the MOS Short Form 36 vitality score.
However, the drug had no effect on acute pressure-point pain or depression (the Montgomery Asberg Depression Rating Scale), the researchers reported.
Overall, the drug was well-tolerated. Of the 150 patients, 19 dropped out due to adverse events, with no significant difference between the treatment groups.
The gabapentin patients reported dizziness, sedation, lightheadedness, and weight gain significantly more often that did the placebo-treated patients. Notably, the researchers said, there was no significant difference in weight change in the two groups as measured in the clinic, although edema may have explained some of the patients' perceptions. Most treatment adverse events, they reported, were mild to moderate in severity.
The pathophysiology of fibromyagia is unknown, but evidence suggests that it is associated with aberrant central nervous system pain processing, the researchers said.
The drug appears to be effective in reducing abnormal hypersensitivity induced by inflammatory responses or nerve injury. Yet unlike many other pain syndromes, there is no physical evidence of inflammation or CNS damage.
One possible explanation, Dr. Arnold said, is that gabapentin's effects involve binding to a specific subunit of voltage-gated calcium channels on neurons. This binding, she said, reduces calcium flow into the nerve cell, which reduces the release of some signaling molecules involved in pain processing.
In discussing the study's limitations, the researchers said that because the study was short, the results may not generalize to longer treatment periods, and long-term efficacy should be studied in future clinical trials.
Also, because the study was relatively small, they said it may have lacked the power to detect potentially relevant differences between the groups. Finally, they wrote that the results may not apply to patients with some comorbid psychiatric disorders, such as bipolar disorder, or to patients with other painful musculoskeletal disorders.
"In this, the first randomized, placebo-controlled study to evaluate gabapentin in the treatment of fibromyalgia, the results demonstrated that gabapentin, taken for up to 12 weeks, is effective and safe in the treatment of pain and other symptoms associated with fibromyalgia," Dr. Arnold concluded.
Primary source: Arthritis and Rheumatism
Source reference:
Arnold LM, et al "Gabapentin in the Treatment of Fibromyalgia: A Randomized, Double-Blind, Placebo-Controlled, Multicenter Trial" Arthritis Rheum 2007; 56: 1336-1344.
--------------------------------------------------------------------------------
Disclaimer
The information presented in this activity is that of the authors and does not necessarily represent the views of the University of Pennsylvania School of Medicine, MedPage Today, and the commercial supporter. Specific medicines discussed in this activity may not yet be approved by the FDA for the use as indicated by the writer or reviewer. Before prescribing any medication, we advise you to review the complete prescribing information, including indications, contraindications, warnings, precautions, and adverse effects. Specific patient care decisions are the responsibility of the healthcare professional caring for the patient. Please review our Terms of Use.
http://www.medpageto...thritis/tb/5930
Iosto'conChiara
Quando le voci in te parlano di fine;
quando la mente dice che hai perduto;
quando credi che sia impossibile;
eppure prosegui,ti sollevi sulla tua Spada;
e fai ancora un altro passo;
Lì è dove termina l'Uomo;
Lì è dove comincia Dio.
Mentre si aspettano future ricerche è importante per prima cosa non
nuocere.
Non è vero che i giorni di pioggia sono i più brutti, sono gli unici in cui puoi camminare a testa alta anche se stai piangendo.
"Nessun Medico può dire che una malattia é Incurabile.
Affermarlo é come offendere Dio, la Natura e disprezzare il Creato.
Non esiste malattia, per quanto terribile possa essere,
per la quale Dio non abbia una cura corrispondente".
Paracelso
“Questa realtà è solo un sogno di cui siamo convinti!”
Mio collegamento
Per quanto riguarda l'ipotesi che la CFS possa essere una forma di Depressione Mentale,tutti gli studi hanno contraddetto tale approccio.Per citare un solo ma importante rilievo clinico:i livelli di Cortisolo sono molto bassi nella CFS,al contrario di quelli alterati verso l'alto della Sindrome Depressiva.
Allora, se capiamo che siamo responsabili di ciò che viviamo, già questo cambia del tutto la visione delle cose.
Livello anormalmente alto o basso di cAMP causa difetti di apprendimento e di capacità di memoria,in generale.
Sul cAMP ci sarebbero molte cose da dire al fine di una buona memoria e cognitività,forse lo faro' un giorno sul mio topic,tempo permettendo,ora voglio solo ripetere una verità a cui sono arrivato da qualche anno,aumentare il cAmp nei giovani comporta un miglior apprendimento e memoria,accade l'inverso nelle persone adulte o anziane.Quindi il cervello dei giovani si comporta all'opposto dei cervelli dei vecchi ed anziani questo avviene anche negli animali da laboratorio,questo spiega anche tutta la diatriba sulla Cannabis terapeutica..........negativa nei giovani un toccasana negli anziani,perchè comporta una diminuzione,appunto,del cAmp e quindi potenzia la comunicazione tra neuroni e quindi la memoria,apprendimento e cognitività,mal ridotti nella CFS/ME,fibromialgia,MCS,MBS,ed altre......
https://www.youtube....h?v=ICjFAa2ZbIY
#5
danis
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Grande amico del forum
Inviato 20 giugno 2007 - 14:17:11
"La mente è come un paracadute, funziona solo se si apre" A. Einstein
"tu cerchi la risposta, ma non devi cercare fuori la risposta, la risposta è dentro di te, e però è sbagliata!" Quelo
"tu cerchi la risposta, ma non devi cercare fuori la risposta, la risposta è dentro di te, e però è sbagliata!" Quelo
#6
romy
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Inviato 20 giugno 2007 - 19:53:22
Grazie di cuore Danis,sei sempre splendida.Ciao.Romy
Iosto'conChiara
Quando le voci in te parlano di fine;
quando la mente dice che hai perduto;
quando credi che sia impossibile;
eppure prosegui,ti sollevi sulla tua Spada;
e fai ancora un altro passo;
Lì è dove termina l'Uomo;
Lì è dove comincia Dio.
Mentre si aspettano future ricerche è importante per prima cosa non
nuocere.
Non è vero che i giorni di pioggia sono i più brutti, sono gli unici in cui puoi camminare a testa alta anche se stai piangendo.
"Nessun Medico può dire che una malattia é Incurabile.
Affermarlo é come offendere Dio, la Natura e disprezzare il Creato.
Non esiste malattia, per quanto terribile possa essere,
per la quale Dio non abbia una cura corrispondente".
Paracelso
“Questa realtà è solo un sogno di cui siamo convinti!”
Mio collegamento
Per quanto riguarda l'ipotesi che la CFS possa essere una forma di Depressione Mentale,tutti gli studi hanno contraddetto tale approccio.Per citare un solo ma importante rilievo clinico:i livelli di Cortisolo sono molto bassi nella CFS,al contrario di quelli alterati verso l'alto della Sindrome Depressiva.
Allora, se capiamo che siamo responsabili di ciò che viviamo, già questo cambia del tutto la visione delle cose.
Livello anormalmente alto o basso di cAMP causa difetti di apprendimento e di capacità di memoria,in generale.
Sul cAMP ci sarebbero molte cose da dire al fine di una buona memoria e cognitività,forse lo faro' un giorno sul mio topic,tempo permettendo,ora voglio solo ripetere una verità a cui sono arrivato da qualche anno,aumentare il cAmp nei giovani comporta un miglior apprendimento e memoria,accade l'inverso nelle persone adulte o anziane.Quindi il cervello dei giovani si comporta all'opposto dei cervelli dei vecchi ed anziani questo avviene anche negli animali da laboratorio,questo spiega anche tutta la diatriba sulla Cannabis terapeutica..........negativa nei giovani un toccasana negli anziani,perchè comporta una diminuzione,appunto,del cAmp e quindi potenzia la comunicazione tra neuroni e quindi la memoria,apprendimento e cognitività,mal ridotti nella CFS/ME,fibromialgia,MCS,MBS,ed altre......
https://www.youtube....h?v=ICjFAa2ZbIY
#7
danis
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Inviato 20 giugno 2007 - 20:35:45
Grazie di cuore Danis,sei sempre splendida.Ciao.Romy
mi fai arrossire.... Mi piacerebbe sapere che pensi di questa ricerca, piuttosto.
grazie
"La mente è come un paracadute, funziona solo se si apre" A. Einstein
"tu cerchi la risposta, ma non devi cercare fuori la risposta, la risposta è dentro di te, e però è sbagliata!" Quelo
"tu cerchi la risposta, ma non devi cercare fuori la risposta, la risposta è dentro di te, e però è sbagliata!" Quelo
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