Real‐world effectiveness and tolerability of carbamazepine and oxcarbazepine in 354 patients with trigeminal neuralgia
Background It is widely agreed that carbamazepine and oxcarbazepine are highly effective in the long‐term treatment of trigeminal neuralgia. However, the tolerability of these drugs across the different aetiologies of trigeminal neuralgia is still undetermined. Methods In this retrospective, real‐wo...
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| Veröffentlicht in: | European journal of pain 2021-05, Vol.25 (5), p.1064-1071 |
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| creator | Di Stefano, Giulia De Stefano, Gianfranco Leone, Caterina Di Lionardo, Andrea Di Pietro, Giuseppe Sgro, Emanuele Mollica, Cristina Cruccu, Giorgio Truini, Andrea |
| description | Background
It is widely agreed that carbamazepine and oxcarbazepine are highly effective in the long‐term treatment of trigeminal neuralgia. However, the tolerability of these drugs across the different aetiologies of trigeminal neuralgia is still undetermined.
Methods
In this retrospective, real‐world study, we assessed the effectiveness and tolerability of carbamazepine and oxcarbazepine in a large cohort of patients with classical (254 patients), secondary (60 patients) and idiopathic (40 patients) trigeminal neuralgia. We analysed data using a propensity score analysis to account for selection bias; frequencies of side effects associated with carbamazepine and oxcarbazepine were calculated by adjusting data with the inverse probability of treatment weighting.
Results
The initial proportion of responders was 88.3% with carbamazepine, and 90.9% with oxcarbazepine. The number of refractory patients was significantly higher in idiopathic (15%) and secondary forms (27%) than in classical trigeminal neuralgia (6%; p |
| doi_str_mv | 10.1002/ejp.1727 |
| format | Article |
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It is widely agreed that carbamazepine and oxcarbazepine are highly effective in the long‐term treatment of trigeminal neuralgia. However, the tolerability of these drugs across the different aetiologies of trigeminal neuralgia is still undetermined.
Methods
In this retrospective, real‐world study, we assessed the effectiveness and tolerability of carbamazepine and oxcarbazepine in a large cohort of patients with classical (254 patients), secondary (60 patients) and idiopathic (40 patients) trigeminal neuralgia. We analysed data using a propensity score analysis to account for selection bias; frequencies of side effects associated with carbamazepine and oxcarbazepine were calculated by adjusting data with the inverse probability of treatment weighting.
Results
The initial proportion of responders was 88.3% with carbamazepine, and 90.9% with oxcarbazepine. The number of refractory patients was significantly higher in idiopathic (15%) and secondary forms (27%) than in classical trigeminal neuralgia (6%; p < .05). In 53 patients treated with carbamazepine (29.6%) and in 22 treated with oxcarbazepine (12.6%), major side effects caused treatment interruption or dosage reduction to an unsatisfactory level. Side effects occurred more frequently in patients treated with carbamazepine (43.6%) than with oxcarbazepine (30.3%, p < .0001). The frequency of treatment discontinuation was higher in patients with secondary and idiopathic forms than in those with classical trigeminal neuralgia (p < .05).
Conclusions
Our real‐world study shows that carbamazepine and oxcarbazepine are effective in most patients with trigeminal neuralgia; nevertheless, side effects are still a major issue, particularly in patients with secondary and idiopathic trigeminal neuralgia.
Significance
Although carbamazepine and oxcarbazepine are effective in most patients with trigeminal neuralgia, their side effects are still a major issue, thus necessitating the development of better‐tolerated drugs.</description><identifier>ISSN: 1090-3801</identifier><identifier>EISSN: 1532-2149</identifier><identifier>DOI: 10.1002/ejp.1727</identifier><identifier>PMID: 33428801</identifier><language>eng</language><publisher>England</publisher><subject>Anticonvulsants - adverse effects ; Benzodiazepines - therapeutic use ; Carbamazepine - adverse effects ; Humans ; Oxcarbazepine ; Retrospective Studies ; Trigeminal Neuralgia - drug therapy</subject><ispartof>European journal of pain, 2021-05, Vol.25 (5), p.1064-1071</ispartof><rights>2021 European Pain Federation ‐ EFIC</rights><rights>2021 European Pain Federation - EFIC®.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3217-84260f5002585d6d6c8dfa66840409dbd037f301a2265866a46a78945148ea03</citedby><cites>FETCH-LOGICAL-c3217-84260f5002585d6d6c8dfa66840409dbd037f301a2265866a46a78945148ea03</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fejp.1727$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fejp.1727$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,780,784,1417,27924,27925,45574,45575</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33428801$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Di Stefano, Giulia</creatorcontrib><creatorcontrib>De Stefano, Gianfranco</creatorcontrib><creatorcontrib>Leone, Caterina</creatorcontrib><creatorcontrib>Di Lionardo, Andrea</creatorcontrib><creatorcontrib>Di Pietro, Giuseppe</creatorcontrib><creatorcontrib>Sgro, Emanuele</creatorcontrib><creatorcontrib>Mollica, Cristina</creatorcontrib><creatorcontrib>Cruccu, Giorgio</creatorcontrib><creatorcontrib>Truini, Andrea</creatorcontrib><title>Real‐world effectiveness and tolerability of carbamazepine and oxcarbazepine in 354 patients with trigeminal neuralgia</title><title>European journal of pain</title><addtitle>Eur J Pain</addtitle><description>Background
It is widely agreed that carbamazepine and oxcarbazepine are highly effective in the long‐term treatment of trigeminal neuralgia. However, the tolerability of these drugs across the different aetiologies of trigeminal neuralgia is still undetermined.
Methods
In this retrospective, real‐world study, we assessed the effectiveness and tolerability of carbamazepine and oxcarbazepine in a large cohort of patients with classical (254 patients), secondary (60 patients) and idiopathic (40 patients) trigeminal neuralgia. We analysed data using a propensity score analysis to account for selection bias; frequencies of side effects associated with carbamazepine and oxcarbazepine were calculated by adjusting data with the inverse probability of treatment weighting.
Results
The initial proportion of responders was 88.3% with carbamazepine, and 90.9% with oxcarbazepine. The number of refractory patients was significantly higher in idiopathic (15%) and secondary forms (27%) than in classical trigeminal neuralgia (6%; p < .05). In 53 patients treated with carbamazepine (29.6%) and in 22 treated with oxcarbazepine (12.6%), major side effects caused treatment interruption or dosage reduction to an unsatisfactory level. Side effects occurred more frequently in patients treated with carbamazepine (43.6%) than with oxcarbazepine (30.3%, p < .0001). The frequency of treatment discontinuation was higher in patients with secondary and idiopathic forms than in those with classical trigeminal neuralgia (p < .05).
Conclusions
Our real‐world study shows that carbamazepine and oxcarbazepine are effective in most patients with trigeminal neuralgia; nevertheless, side effects are still a major issue, particularly in patients with secondary and idiopathic trigeminal neuralgia.
Significance
Although carbamazepine and oxcarbazepine are effective in most patients with trigeminal neuralgia, their side effects are still a major issue, thus necessitating the development of better‐tolerated drugs.</description><subject>Anticonvulsants - adverse effects</subject><subject>Benzodiazepines - therapeutic use</subject><subject>Carbamazepine - adverse effects</subject><subject>Humans</subject><subject>Oxcarbazepine</subject><subject>Retrospective Studies</subject><subject>Trigeminal Neuralgia - drug therapy</subject><issn>1090-3801</issn><issn>1532-2149</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kMtKw0AUhgdRbK2CTyCzdJN65pLJdCml3igo0n04TU7qlDQJk9S2rnwEn9EnMb3oztX5-fn44XyMXQroCwB5Q_OqLyIZHbGuCJUMpNCD4zbDAAJlQXTYWV3PAUBHoE5ZRyktbdt32fqVMP_-_FqVPk85ZRkljXunguqaY5HypszJ49TlrtnwMuMJ-iku8IMqV9COKNe77tC4gqtQ8wobR0VT85Vr3njj3YwWrsCcF7T0mM8cnrOTDPOaLg63xyZ3o8nwIRg_3z8Ob8dBoqSIAqulgSxsnwxtmJrUJDbN0BirQcMgnaagokyBQClNaI1BbTCyAx0KbQlB9dj1fjbxZV17yuLKuwX6TSwg3rqLW3fx1l2LXu3RajldUPoH_spqgWAPrFxOm3-H4tHTy27wB49ded4</recordid><startdate>202105</startdate><enddate>202105</enddate><creator>Di Stefano, Giulia</creator><creator>De Stefano, Gianfranco</creator><creator>Leone, Caterina</creator><creator>Di Lionardo, Andrea</creator><creator>Di Pietro, Giuseppe</creator><creator>Sgro, Emanuele</creator><creator>Mollica, Cristina</creator><creator>Cruccu, Giorgio</creator><creator>Truini, Andrea</creator><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope></search><sort><creationdate>202105</creationdate><title>Real‐world effectiveness and tolerability of carbamazepine and oxcarbazepine in 354 patients with trigeminal neuralgia</title><author>Di Stefano, Giulia ; De Stefano, Gianfranco ; Leone, Caterina ; Di Lionardo, Andrea ; Di Pietro, Giuseppe ; Sgro, Emanuele ; Mollica, Cristina ; Cruccu, Giorgio ; Truini, Andrea</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3217-84260f5002585d6d6c8dfa66840409dbd037f301a2265866a46a78945148ea03</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Anticonvulsants - adverse effects</topic><topic>Benzodiazepines - therapeutic use</topic><topic>Carbamazepine - adverse effects</topic><topic>Humans</topic><topic>Oxcarbazepine</topic><topic>Retrospective Studies</topic><topic>Trigeminal Neuralgia - drug therapy</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Di Stefano, Giulia</creatorcontrib><creatorcontrib>De Stefano, Gianfranco</creatorcontrib><creatorcontrib>Leone, Caterina</creatorcontrib><creatorcontrib>Di Lionardo, Andrea</creatorcontrib><creatorcontrib>Di Pietro, Giuseppe</creatorcontrib><creatorcontrib>Sgro, Emanuele</creatorcontrib><creatorcontrib>Mollica, Cristina</creatorcontrib><creatorcontrib>Cruccu, Giorgio</creatorcontrib><creatorcontrib>Truini, Andrea</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><jtitle>European journal of pain</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Di Stefano, Giulia</au><au>De Stefano, Gianfranco</au><au>Leone, Caterina</au><au>Di Lionardo, Andrea</au><au>Di Pietro, Giuseppe</au><au>Sgro, Emanuele</au><au>Mollica, Cristina</au><au>Cruccu, Giorgio</au><au>Truini, Andrea</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Real‐world effectiveness and tolerability of carbamazepine and oxcarbazepine in 354 patients with trigeminal neuralgia</atitle><jtitle>European journal of pain</jtitle><addtitle>Eur J Pain</addtitle><date>2021-05</date><risdate>2021</risdate><volume>25</volume><issue>5</issue><spage>1064</spage><epage>1071</epage><pages>1064-1071</pages><issn>1090-3801</issn><eissn>1532-2149</eissn><abstract>Background
It is widely agreed that carbamazepine and oxcarbazepine are highly effective in the long‐term treatment of trigeminal neuralgia. However, the tolerability of these drugs across the different aetiologies of trigeminal neuralgia is still undetermined.
Methods
In this retrospective, real‐world study, we assessed the effectiveness and tolerability of carbamazepine and oxcarbazepine in a large cohort of patients with classical (254 patients), secondary (60 patients) and idiopathic (40 patients) trigeminal neuralgia. We analysed data using a propensity score analysis to account for selection bias; frequencies of side effects associated with carbamazepine and oxcarbazepine were calculated by adjusting data with the inverse probability of treatment weighting.
Results
The initial proportion of responders was 88.3% with carbamazepine, and 90.9% with oxcarbazepine. The number of refractory patients was significantly higher in idiopathic (15%) and secondary forms (27%) than in classical trigeminal neuralgia (6%; p < .05). In 53 patients treated with carbamazepine (29.6%) and in 22 treated with oxcarbazepine (12.6%), major side effects caused treatment interruption or dosage reduction to an unsatisfactory level. Side effects occurred more frequently in patients treated with carbamazepine (43.6%) than with oxcarbazepine (30.3%, p < .0001). The frequency of treatment discontinuation was higher in patients with secondary and idiopathic forms than in those with classical trigeminal neuralgia (p < .05).
Conclusions
Our real‐world study shows that carbamazepine and oxcarbazepine are effective in most patients with trigeminal neuralgia; nevertheless, side effects are still a major issue, particularly in patients with secondary and idiopathic trigeminal neuralgia.
Significance
Although carbamazepine and oxcarbazepine are effective in most patients with trigeminal neuralgia, their side effects are still a major issue, thus necessitating the development of better‐tolerated drugs.</abstract><cop>England</cop><pmid>33428801</pmid><doi>10.1002/ejp.1727</doi><tpages>8</tpages></addata></record> |
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| subjects | Anticonvulsants - adverse effects Benzodiazepines - therapeutic use Carbamazepine - adverse effects Humans Oxcarbazepine Retrospective Studies Trigeminal Neuralgia - drug therapy |
| title | Real‐world effectiveness and tolerability of carbamazepine and oxcarbazepine in 354 patients with trigeminal neuralgia |
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