Journal Article

The Effect of Gabapentin Enacarbil on Pain Associated with Moderate-to-Severe Primary Restless Legs Syndrome in Adults: Pooled Analyses from Three Randomized Controlled Trials

Ellenbogen, Aaron, Irving, Gordon, Shang, Gwendoline, Kim, Richard, Hermanowicz, Neal, Buchfuhrer, Mark, Jaros, Mark J.

2016

Overview

Background Adults with moderate-to-severe primary restless legs syndrome (RLS) often experience painful dysesthesias, which may lead to impaired quality of life. Objectives The aim of this study was to assess the effects of gabapentin enacarbil (GEn) on pain associated with moderate-to-severe primary RLS in adults. Methods Data were pooled from three double-blind, randomized, placebo-controlled, 12-week trials (NCT00298623, NCT00365352, NCT01332305) for adults receiving GEn or placebo once daily. Change in average daily RLS pain score and a combined International Restless Legs Scale (IRLS)–pain response were examined. Results The modified intention-to-treat population included 671 adults (placebo, n  = 244; GEn 600 mg, n  = 161; GEn 1200 mg, n  = 266). Both GEn doses significantly improved average daily RLS pain score at week 12 ( p  < 0.001 for GEn 600 mg vs. placebo and GEn 1200 mg vs. placebo). The combined IRLS–pain response subanalysis included 366 patients with a baseline IRLS total score ≥15 and pain score ≥4 (placebo, n = 133; GEn 600 mg, n = 86; GEn 1200 mg, n  = 147). Most patients were both IRLS and pain responders (placebo, 40 %; GEn 600 mg, 70 %; GEn 1200 mg, 67 %). Spearman rank correlations between IRLS total and pain score (change from baseline to week 12) were moderate or strong. The most frequent treatment-emergent adverse events were somnolence (placebo, 5 %; GEn 600 mg, 20 %; GEn 1200 mg, 23 %) and dizziness (placebo, 4 %; GEn 600 mg, 13 %; GEn 1200 mg, 22 %). Conclusions This post hoc pooled analysis suggests that GEn (600 and 1200 mg) once daily significantly improved pain associated with moderate-to-severe primary RLS in adults; however, the analysis was not powered to detect statistical differences between the two GEn doses. Numerically, more GEn-treated patients had a combined IRLS–pain response than placebo-treated patients.

• Publisher: Springer International Publishing,Springer Nature B.V
• Subject: Adult / Adults / Aged / Carbamates - therapeutic use / Clinical trials / Dopamine Agonists - therapeutic use / Dose-Response Relationship, Drug / Double-Blind Method / Ethics / Female / gamma-Aminobutyric Acid - analogs & derivatives / gamma-Aminobutyric Acid - therapeutic use / Humans / Male / Medicine / Medicine & Public Health / Middle Aged / Neurology / Neurosciences / Original Research Article / Pain / Pain - drug therapy / Pain - etiology / Pharmacotherapy / Psychiatry / Psychopharmacology / Quality of Life / Randomized Controlled Trials as Topic / Restless legs syndrome / Restless Legs Syndrome - complications / Sleep / Studies / Treatment Outcome / Young Adult