The combined analgesic effect of pregabalin and morphine in the treatment of pancreatic cancer pain, a retrospective study

Background Pregabalin is commonly used to relieve neuropathic pain. However, data are lacking on its efficacy for the treatment of chronic cancer pain. The purpose of this study was to determine the analgesic efficacy of pregabalin combined with morphine in the management of pancreatic cancer pain. Methods This study reviewed patients who were prescribed morphine and 150 mg/d pregabalin between 1 January 2017 and 10 November 2018 in our institute. The primary outcomes of this study were the average pain score and dose of morphine. Secondary outcomes included characters of breakthrough cancer pain, functional interference related to pain, anxiety/depression status, and incidence of treatment-related adverse events during the study. Results A total of 240 patients with pain related to pancreatic cancer were included in the study. The results showed that patients of both combination therapy group (pregabalin+morphine) and monotherapy group (morphine) achieved similar analgesic efficacy, demonstrated by NRS (2.4 +/- 0.9 vs. 2.6 +/- 0.9; combination vs. monotherapy) at the end of the study. Mean daily dose of morphine used in the combination group was significant lower compared to monotherapy group (39.5 +/- 16.0 mg vs. 61.5 +/- 19.3 mg, net difference 23.5, 95% CI: 18.4-28.6, p < 0.001). The change of functional interference score related to pain was significantly different between combination and monotherapy group (12.0 +/- 0.4 vs. 9.8 +/- 4.9; net difference, 2.3; 95% CI: 1.1-3.3; p < 0.001). Patients in combination therapy group had experienced shorter duration of breakthrough cancer pain than those in monotherapy group (X-2 p < 0.001, Cramer's V:0.36). The incidence of somnolence, dizziness, and cognitive dysfunction were significantly higher in the combination group compared to monotherapy group. No serious treatment-related side effects were observed. Conclusions The findings of this study supported the use of pregabalin with morphine to relieve pain in patients of pancreatic cancer.

Automated summary

The study showed that combining pregabalin with morphine for pancreatic cancer pain management resulted in similar analgesic efficacy compared to using morphine alone, but with a significant lower dose of morphine in the combination group. Functional interference scores also differed significantly between the two groups.