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Pregabalin, celecoxib, and their combination for treatment of chronic low-back pain.

Author(s): Romano CL, Romano D, Bonora C, Mineo G

Affiliation(s): Istituto Ortopedico I.R.C.C.S. Galeazzi, Via Riccardo Galeazzi, 4, 20166, Milan, Italy. carlo.romano@grupposandonato.it

Publication date & source: 2009-12, J Orthop Traumatol., 10(4):185-91. Epub 2009 Nov 18.

Publication type: Randomized Controlled Trial

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. MATERIALS AND 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.

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