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Randomized Controlled Trial
Predicting response to pregabalin from pretreatment pain quality: clinical applications of the pain quality assessment scale.
- Arnold R Gammaitoni, Steven S Smugar, Mark P Jensen, Bradley S Galer, James A Bolognese, Achilles Alon, and David J Hewitt.
- Global Center for Scientific Affairs, Merck Sharp & Dohme Corp., Whitehouse Station, New Jersey, USA.
- Pain Med. 2013 Apr 1; 14 (4): 526-32.
ObjectiveThe aim of this study is to assess the Pain Quality Assessment Scale (PQAS) in predicting pregabalin in peripheral neuropathic pain (NP).Study DesignPost hoc analysis of a double-blind, placebo-controlled, enriched enrollment, randomized withdrawal trial evaluating pregabalin in 99 patients with NP who completed the PQAS, which comprises 20 questions regarding individual pain domains and qualities that are scored into three scales: paroxysmal, deep, and surface.MethodsPatients rated the average pain intensity and pain quality using the PQAS at baseline; average pain intensity was assessed again after 40 days of treatment with pregabalin. Associations between pretreatment PQAS scores and treatment response were estimated using Pearson's r. Logistic regression was used to identify pretitration PQAS scores contributing unique variance to predicting treatment response.ResultsFifty participants provided baseline PQAS scores and received pregabalin for the entire length of the study. Nine of 23 PQAS baseline scales and items were significantly associated with treatment response to pregabalin: the paroxysmal and deep scales, and the items assessing the following pain domains and qualities: intensity, electric, tingling, cramping, radiating, throbbing, and deep (P values range, 0.002-0.045; rs range, 0.28-0.43). The PQAS items assessing sharp, hot, and unpleasant pain items demonstrated nonsignificant trends (P < 0.10) to be associated with treatment response. In the logistic regression analysis, pretitration PQAS scores had 77% sensitivity and 83% specificity to correctly identify pregabalin responders. Significantly correlated PQAS items had a sensitivity of 85% and specificity of 76%.ConclusionPretitration PQAS scores reliably predicted pregabalin responders in patients with NP.Wiley Periodicals, Inc.
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