Drug Usability Survey (DUS) of Gabapentinoid and Its Combinations Among Indian Patients With Neuropathic Pain: Results From a Real-World, Multicenter, Retrospective Survey at Neurology Clinics.

Introduction:  Neuropathic pain of various etiology is the most commonly reported at primary clinics by patients. Patients experience moderate to severe chronic pain, impacting quality of life (QoL) and mood. The mainstay of the treatment includes gabapentinoid-based treatment to reduce pain severity and improve the QoL for the patients.

Methods:  In a retrospective cross-sectional survey in India, the drug usability of gabapentinoid-based treatment in various neuropathic pain was studied. This included data collection from various neurological clinics across India that considered patient demographics, comorbidities, type of neuropathies, the percentage of patients receiving gabapentinoid-based treatment, the share of diabetic patients and diabetic neuropathy, and the severity of pain reported by patients.

Results:  The cross-sectional survey was conducted at 51 neurology clinics involving 2,251 patients. Patients presented with neuropathic pain of various etiologies, of which diabetic neuropathy was the most prevalent condition. Among the patients, 59.30% (1,252) consulted the neurologist for the first time, whereas 40.70% (860) of patients visited the clinic for follow-up. Neurologists prescribed gabapentinoid-based combination treatment as the main preferred treatment. Duloxetine, a selective serotonin and norepinephrine reuptake inhibitor (SSNRI) antidepressant, and nortriptyline, a tricyclic antidepressant (TCA), were the most preferred agents used in combination with pregabalin and gabapentin. Patients who visited for follow-up reported pain reduction and improved QoL with the treatment provided by the neurologists.

Conclusion: Gabapentinoid-based treatments combined with TCA and SSNRI are useful and well-accepted treatment modalities by neurologists in painful neuropathies. Gabapentinoids are non-opioids with no risk of abuse and addiction and were considered the first line of therapy for various types of neuropathic pain.