title: Efficacy of combination of meloxicam and pregabalin for pain in knee osteoarthritis.
abstract: OBJECTIVE
  Osteoarthritic pain is largely considered to be inflammatory pain. Sensory nerve fibers innervating the knee have been shown to be significantly damaged in rat models of knee osteoarthritis (OA) in which the subchondral bone junction is destroyed, and this induces neuropathic pain (NP). Pregabalin was developed as a pain killer for NP; however, there are no reports on pregabalin use in OA patients. The purpose of this study was to investigate the efficacy of pregabalin for pain in OA patients.
  
  
  METHODS
  Eighty-nine knee OA patients were evaluated in this randomized prospective study. Patients were divided into meloxicam, pregabalin, and meloxicam+pregabalin groups. Pain scores were evaluated before and 4 weeks after drug application using a visual analogue scale (VAS), and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Pain scales among groups were compared using a Kruskal-Wallis test.
  
  
  RESULTS
  Before drug application, there was no significant difference in VAS and WOMAC scores among the three groups (p>0.05). Significant pain relief was seen in the meloxicam+pregabalin group in VAS at 1, 2, and 4 weeks, and WOMAC score at 4 weeks, compared with the other groups (p<0.05). No significant pain relief was seen in the meloxicam only group in VAS during 4 weeks and WOMAC score at 4 weeks compared with the pregabalin only group (p>0.05).
  
  
  CONCLUSIONS
  Meloxicam+pregabalin was effective for pain in OA patients. This finding suggests that OA pain is a combination of inflammatory and NP.
authors.affiliation: Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba 260-8670, Japan. sohtori@faculty.chiba-u.jp
authors.forename: Seiji
authors.initials: S
authors.lastname: Ohtori
authors.forename: Gen
authors.initials: G
authors.lastname: Inoue
authors.forename: Sumihisa
authors.initials: S
authors.lastname: Orita
authors.forename: Masashi
authors.initials: M
authors.lastname: Takaso
authors.forename: Yawara
authors.initials: Y
authors.lastname: Eguchi
authors.forename: Nobuyasu
authors.initials: N
authors.lastname: Ochiai
authors.forename: Shunji
authors.initials: S
authors.lastname: Kishida
authors.forename: Kazuki
authors.initials: K
authors.lastname: Kuniyoshi
authors.forename: Yasuchika
authors.initials: Y
authors.lastname: Aoki
authors.forename: Tetsuhiro
authors.initials: T
authors.lastname: Ishikawa
authors.forename: Masayuki
authors.initials: M
authors.lastname: Miyagi
authors.forename: Hiroto
authors.initials: H
authors.lastname: Kamoda
authors.forename: Miyako
authors.initials: M
authors.lastname: Suzkuki
authors.forename: Junichi
authors.initials: J
authors.lastname: Nakamura
authors.forename: Gou
authors.initials: G
authors.lastname: Kubota
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Sakuma
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Oikawa
authors.forename: Tomoaki
authors.initials: T
authors.lastname: Toyone
authors.forename: Kazuhide
authors.initials: K
authors.lastname: Inage
authors.forename: Takeshi
authors.initials: T
authors.lastname: Sainoh
authors.forename: Kazuyo
authors.initials: K
authors.lastname: Yamauchi
authors.forename: Kazuhisa
authors.initials: K
authors.lastname: Takahashi
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D004359:Drug Therapy, Combination / Q000009:adverse effects; D005260:Female; D006801:Humans; D008297:Male; D000077239:Meloxicam; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000188:drug therapy*; D010147:Pain Measurement; D000069583:Pregabalin; D013843:Thiazines / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D013844:Thiazoles / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D005680:gamma-Aminobutyric Acid / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use
chemical_list: D013843:Thiazines; D013844:Thiazoles; D000069583:Pregabalin; D005680:gamma-Aminobutyric Acid; D000077239:Meloxicam
keywords: Pain; inflammatory; knee; nerve; neuropathic; osteoarthritis; pregabalin
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