Publication
Rapid paediatric program-gabapentinoids for pain
Drake R, Hunt J, Herbert A, Hynson J, Currow D, Doogue M, Phillips M, Cossich M, Rowett D · Palliative Medicine · 2021
Background: The Rapid Program Paediatric series seeks to establish the broad utility and adverse effects (AE) of frequently used drugs in 'real life' paediatric palliative care (PPC). It is designed to minimise workload for individual sites through multi-site collaboration and enable Rapid and easy data collection. The Gabapentinoids (gabapentin and pregabalin) are used to manage neuropathic and nociplastic pain in PPC with the two groups most likely to benefit being children with cancer-related neuropathic pain or painassociated with severe neurological injury. Clinical use of gabapentin or pregabalin is only supported by very lowquality evidence in children's pain management. However, a pointer to the potential 'real life' action of these medications comes from two 2015 pharmacovigilance studies in adult palliative care. Aim(s): To examine the effectiveness of gabapentinoids in relieving pain in PPC. Method(s): This international, multisite, prospective observational consecutive cohort study assessed pain and symptoms at baseline (commencement of gabapentinoid) (T0) then assessment of medication effectiveness and AE at 14 days (T1), 28 days (T2), 6 weeks (T3) and 12 weeks (T4) after baseline. AE were measured using NCI Common Terminology Criteria for AE. Result(s): Data for 144 patients (M76:F68) with a median age of 9 yrs (range < 1 to 18 yrs) were completed. The most common life limiting illnesses were neurological conditions (55%) and advanced cancer (23%). The median Performance Score (Lansky or Australian Karnofsky) of 141 children was 55% indicating a moderate to high level of disability amongst this cohort. Ninety-five percent of patients were commenced on gabapentin with analysis of dosing, effectiveness and adverse events experienced pending. Conclusion(s): The results of this series will be presented including baseline pain scores, improvement over time and any adverse harms that occurred throughout the study period.
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