title: Time to improvement of pain and sleep quality in clinical trials of pregabalin for the treatment of fibromyalgia.
abstract: OBJECTIVE
  To determine the time to immediate and sustained clinical improvement in pain and sleep quality with pregabalin in patients with fibromyalgia.
  
  
  METHODS
  A post hoc analysis of four 8- to 14-week phase 2-3, placebo-controlled trials of fixed-dose pregabalin (150-600 mg/day) for fibromyalgia, comprising 12 pregabalin and four placebo treatment arms.
  
  
  METHODS
  A total of 2,747 patients with fibromyalgia, aged 18-82 years.
  
  
  METHODS
  Pain and sleep quality scores, recorded daily on 11-point numeric rating scales (NRSs), were analyzed to determine time to immediate improvement with pregabalin, defined as the first of ≥2 consecutive days when the mean NRS score was significantly lower for pregabalin vs placebo in those treatment arms with a significant improvement at endpoint, and time to sustained clinical improvement with pregabalin, defined as a ≥1-point reduction of the baseline NRS score of patient responders who had a ≥30% improvement on the pain NRS, sleep NRS, or Fibromyalgia Impact Questionnaire (FIQ) from baseline to endpoint, or who reported "much improved" or "very much improved" on the Patient Global Impression of Change (PGIC) at endpoint.
  
  
  RESULTS
  Significant improvements in pain and sleep quality scores at endpoint vs placebo were seen in 8/12 and 11/12 pregabalin treatment arms, respectively (P < 0.05). In these arms, time to immediate improvements in pain or sleep occurred by day 1 or 2. Time to sustained clinical improvement occurred significantly earlier in pain, sleep, PGIC, and FIQ responders (P < 0.02) with pregabalin vs placebo.
  
  
  CONCLUSIONS
  Both immediate and sustained clinical improvements in pain and sleep quality occurred faster with pregabalin vs placebo.
authors.affiliation: University of Cincinnati College of Medicine, Cincinnati, Ohio.
authors.forename: Lesley M
authors.initials: LM
authors.lastname: Arnold
authors.forename: Birol
authors.initials: B
authors.lastname: Emir
authors.forename: Lynne
authors.initials: L
authors.lastname: Pauer
authors.forename: Malca
authors.initials: M
authors.lastname: Resnick
authors.forename: Andrew
authors.initials: A
authors.lastname: Clair
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000700:Analgesics / Q000627:therapeutic use*; D005260:Female; D005356:Fibromyalgia / Q000150:complications* / Q000188:drug therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000188:drug therapy* / Q000209:etiology; D000069583:Pregabalin / Q000627:therapeutic use*; D012890:Sleep / Q000187:drug effects*; D013997:Time Factors; D055815:Young Adult
chemical_list: D000700:Analgesics; D000069583:Pregabalin
keywords: Fibromyalgia; Pain; Pregabalin; Sleep; Time to Improvement