Clinical Outcomes of Mirogabalin Treatment for Neuropathic Pain Due to Spinal Diseases in Patients Intolerant to Continuous Administration of Pregabalin.

Introduction: We often treat patients with peripheral neuropathic pain due to spine diseases with mirogabalin as an alternative to pregabalin because of adverse events or insufficient efficacy associated with pregabalin treatment. However, there have been few reports on the safety and efficacy of mirogabalin in such cases. This study aimed to evaluate the safety and efficacy of switching from pregabalin to mirogabalin in patients with peripheral neuropathic pain due to spine diseases. Methods: Between January 2019 and July 2021, we treated 106 patients (47 men and 59 women) with peripheral neuropathic pain due to spine diseases. All patients had switched from pregabalin to mirogabalin due to adverse events or lack of efficacy. We evaluated the retention rate, incidence of adverse events, and response rate of mirogabalin during the treatment course. Results: The mean age of the patients was 67.5 years (range, 33-93 years), and the average dose of mirogabalin was 13.8 mg (range, 2.5-30 mg) at the final follow-up. The average duration of mirogabalin treatment was 148.7 days (range, 3-463 days). The retention rate of mirogabalin was 78.3%, the incidence of adverse events after mirogabalin administration was 28.3%, and the response rate of mirogabalin was 66%. Somnolence with pregabalin or mirogabalin administration in the mirogabalin discontinuation group was increased compared with that in the mirogabalin continuation group (pregabalin: 52.2% vs. 19.3%, mirogabalin: 26.1% vs. 7.2%). The patients who responded to mirogabalin had a lower average age, higher retention rate, and longer drug administration period than those who did not respond to it. Conclusions: This study indicated that mirogabalin treatment might be continued in patients with peripheral neuropathic pain due to spinal diseases who could not continue pregabalin treatment.