Pregabalin, celecoxib, and their combination for treatment of chronic low-back pain.
BACKGROUND
The efficacy and safety of the association of celecoxib [a selective cyclooxygenase-2 (COX-2) inhibitor] and pregabalin (commonly used to control neuropathic pain), compared with monotherapy of each, were evaluated for the treatment of chronic low-back pain, a condition known to be due to neuropathic as well as nociceptive pain mechanisms.


METHODS
In this prospective randomized trial, 36 patients received three consecutive 4-week treatment regimes, randomly assigned: celecoxib plus placebo, pregabalin plus placebo, and celecoxib plus pregabalin. All patients were assessed by using a visual analogue scale (VAS, 0-100 mm) and the Leeds Assessment of Neuropathic Symptoms and Signs (LANSS) pain scale by an investigator blinded to the administered pharmacological treatment.


RESULTS
Celecoxib and pregabalin were effective in reducing low-back pain when patients were pooled according to LANSS score. The association of celecoxib and pregabalin was more effective than either monotherapy in a mixed population of patients with chronic low-back pain and when data were pooled according to LANSS score. Adverse effects of drug association and monotherapies were similar, with reduced drug consumption in the combined therapy.


CONCLUSIONS
Combination of celecoxib and pregabalin is more effective than monotherapy for chronic low-back pain, with similar adverse effects.
Romanò
Carlo Luca
CL
Istituto Ortopedico I.R.C.C.S. Galeazzi, Via Riccardo Galeazzi, 4, 20166, Milan, Italy. carlo.romano@grupposandonato.it
Romanò
Delia
D
Bonora
Cristina
C
Mineo
Giuseppe
G
D000328:Adult; D000368:Aged; D000700:Analgesics / Q000008:administration & dosage* / Q000009:adverse effects; D000068579:Celecoxib; D002908:Chronic Disease; D052246:Cyclooxygenase 2 Inhibitors / Q000008:administration & dosage* / Q000009:adverse effects; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D017116:Low Back Pain / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D000069583:Pregabalin; D011720:Pyrazoles / Q000008:administration & dosage* / Q000009:adverse effects; D016037:Single-Blind Method; D013449:Sulfonamides / Q000008:administration & dosage* / Q000009:adverse effects; D016896:Treatment Outcome; D005680:gamma-Aminobutyric Acid / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives*
D000700:Analgesics; D052246:Cyclooxygenase 2 Inhibitors; D011720:Pyrazoles; D013449:Sulfonamides; D000069583:Pregabalin; D005680:gamma-Aminobutyric Acid; D000068579:Celecoxib