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  • Pregabalin versus placebo to prevent chronic pain after whiplash injury in at-risk individuals: results of a feasibility study for a large randomised controlled trial

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    Accepted Manuscript (AM)
    Author(s)
    Nikles, Jane
    Keijzers, Gerben
    Mitchell, Geoffrey
    Farrell, Scott F
    Perez, Siegfried
    Schug, Stephan
    Ware, Robert S
    McLean, Samuel A
    Connelly, Luke B
    Sterling, Michele
    Griffith University Author(s)
    Ware, Robert
    Year published
    2022
    Metadata
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    Abstract
    There are few effective treatments for acute whiplash-associated disorders (WAD). Early features of central sensitisation predict poor recovery. The effect of pregabalin on central sensitisation might prevent chronic pain after acute whiplash injury. This double blind, placebo-controlled randomised controlled trial (RCT) examined feasibility and potential effectiveness of pregabalin compared to placebo for people with acute WAD. Twenty-four participants with acute WAD (<48 hours) and at risk of poor recovery (pain ≥ 5/10) were recruited from hospital Emergency Departments in Queensland, Australia and randomly assigned by ...
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    There are few effective treatments for acute whiplash-associated disorders (WAD). Early features of central sensitisation predict poor recovery. The effect of pregabalin on central sensitisation might prevent chronic pain after acute whiplash injury. This double blind, placebo-controlled randomised controlled trial (RCT) examined feasibility and potential effectiveness of pregabalin compared to placebo for people with acute WAD. Twenty-four participants with acute WAD (<48 hours) and at risk of poor recovery (pain ≥ 5/10) were recruited from hospital Emergency Departments in Queensland, Australia and randomly assigned by concealed allocation to either pregabalin (n=10) or placebo (n=14). Pregabalin was commenced at 75 mg bd, titrated to 300 mg bd for 4 weeks, and then weaned over 1 week. Participants were assessed at 5 weeks, 3, 6 and 12 months. Feasibility issues included recruitment difficulties and greater attrition in the placebo group. For the primary clinical outcome of neck pain intensity, attrition at 5 weeks was: pregabalin: 10%, placebo: 36%, and at 12 months was: pregabalin: 10%, placebo: 43%. Pregabalin may be more effective than placebo for the primary clinical outcome of neck pain intensity at 3 months [Mean Difference: -4.0 (95% CI -6.2 to -1.7)] on an eleven point numerical rating scale. Effects were maintained at 6 but not 12 months. There were no serious adverse events. Minor adverse events were more common in the pregabalin group. A definitive large RCT of pregabalin for acute whiplash injury is warranted. Feasibility issues would need to be addressed with modifications to the protocol.
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    Journal Title
    Pain
    Volume
    163
    Issue
    2
    DOI
    https://doi.org/10.1097/j.pain.0000000000002362
    Copyright Statement
    © 2022 LWW. This is a non-final version of an article published in final form in Pain 163 (2), pp. e274-e284, 2021. Reproduced in accordance with the copyright policy of the publisher. Please refer to the journal link for access to the definitive, published version.
    Subject
    Biomedical and clinical sciences
    Psychology
    Publication URI
    http://hdl.handle.net/10072/405155
    Collection
    • Journal articles

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