Pregabalin for the Treatment of Men with Chronic Prostatitis/Chronic Pelvic Pain Syndrome

A Randomized Controlled Trial

Published in: Archives of Internal Medicine, v. 170, no. 17, Sep. 27, 2010, p. 1586-1593

Posted on RAND.org on September 26, 2010

by Michel A. Pontari, John N. Krieger, Mark Litwin, Paige White, Rodney Anderson, Mary McNaughton-Collins, J. Curtis Nickel, Daniel A. Shoskes, Richard B. Alexander, Michael P. O'Leary, Scott Zeitlin, Shannon Chuai, J. Richard Landis, Liyi Cen, Kathleen Joy Propert, John W. Kusek, Leroy M. Nyberg, Anthony J. Schaeffer

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BACKGROUND: Evidence suggests that the urogenital pain of chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) may be neuropathic. METHODS: This randomized, double-blind, placebo-controlled trial was conducted across 10 tertiary care centers in North America to determine whether pregabalin, which has been proved effective in other chronic pain syndromes, is effective in reducing CP/CPPS symptoms. In 2006-2007, 324 men with pelvic pain for at least 3 of the previous 6 months were enrolled in this study. Men were randomly assigned to receive pregabalin or placebo in a 2:1 ratio and were treated for 6 weeks. Pregabalin dosage was increased from 150 to 600 mg/d during the first 4 weeks. The primary outcome was a 6-point decrease in the National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI) total score. Multiple secondary outcomes were assessed. RESULTS: Of 218 men assigned to receive pregabalin, 103 (47.2%) reported at least a 6-point decrease in the NIH-CPSI total score at 6 weeks compared with 35.8% (38 of 106 men) assigned to receive placebo (P = .07, exact Mantel-Haenszel test, adjusting for clinical sites). Compared with the placebo group, men assigned to receive pregabalin experienced reductions in the NIH-CPSI total score and subscores (P < .05), a higher Global Response Assessment response rate (31.2% and 18.9%; P = .02), and improvement in total McGill Pain Questionnaire score (P = .01). Results for the other outcomes did not differ between groups. CONCLUSION: Pregabalin therapy for 6 weeks was not superior to placebo use in the rate of a 6-point decrease (improvement) in the NIH-CPSI total score in men with CP/CPPS.

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