{"paper_id":"be0b75f9-4f14-423b-a97e-303cfcab1419","body_text":"Abstract\nIntroduction and hypothesis\nChronic pelvic pain (CPP) affects 2.1–24% of women, causing physical and psychological damage to women around the world. Based on the efficacy of gabapentin in the treatment of chronic pain, we conducted this study to evaluate the efficacy and safety of gabapentin in reducing pain in women with CPP.\nMethods\nSystematic searches were performed in the electronic databases of PubMed, Embase, Web of Science, Scopus, Cochrane, and Clinicalkey databases. Studies focused on comparing the efficacy of gabapentin and placebo in the treatment of female CPP patients were included. RevMan 5.4 was used to analyze the results and risk of bias. Two investigators independently selected eligible studies and extracted related pain scores and side effects for meta-analysis.\nResults\nIn total, 4 RCTs were enrolled in the meta-analysis, totaling 425 patients. Among patients receiving gabapentin, the average pain scores in 3 and 6 months were significantly lower than those in the placebo group(p < 0.00001). The results showed that there was no statistical difference between gabapentin and placebo in the reduction of pain scores from baseline(p = 0.41). The incidence of side effects in the gabapentin group was significantly higher than that in the placebo group (p < 0.00001).\nConclusion\nThis systematic review and meta-analysis demonstrated that for women with CPP, gabapentin was significantly different from placebo in average pain scores at 3 and 6 months. However, the two drugs did not differ in the reduction in pain scores from baseline. Gabapentin can bring more significant side effects, whether they are common side effects or serious side effects.\nSimilar content being viewed by others\nAbbreviations\n- BMI:\n-\nBody mass index\n- CPP:\n-\nChronic pelvic pain\n- fMRI:\n-\nFunctional magnetic resonance imaging\n- NR:\n-\nNot recorded\n- NRS:\n-\nNumerical rating scale\n- PRISMA:\n-\nPreferred Reporting Items for Systematic Reviews and Meta-Analyses\n- SD:\n-\nStandard deviation\n- VAS:\n-\nVisual analogue scale\nReferences\nSpeer LM, Mushkbar S, Erbele T. Chronic pelvic pain in women. Am Fam Physician. 2016;93:380–7.\nLatthe P, Latthe M, Say L, Gülmezoglu M, Khan KS. WHO systematic review of prevalence of chronic pelvic pain: a neglected reproductive health morbidity. BMC Public Health. 2006;6:177.\nZondervan KT, Yudkin PL, Vessey MP, Dawes MG, Barlow DH, Kennedy SH. Prevalence and incidence of chronic pelvic pain in primary care: evidence from a national general practice database. Br J Obstet Gynaecol. 1999;106:1149–55.\nChronic Pelvic Pain: ACOG Practice Bulletin, Number 218. Obstet Gynecol. 2020;135:e98–e109.\nBrawn J, Morotti M, Zondervan KT, Becker CM, Vincent K. Central changes associated with chronic pelvic pain and endometriosis. Hum Reprod Update. 2014;20:737–47.\nDaniels JP, Khan KS. Chronic pelvic pain in women. BMJ. 2010;341:c4834.\nAyorinde AA, Macfarlane GJ, Saraswat L, Bhattacharya S. Chronic pelvic pain in women: an epidemiological perspective. Womens Health (Lond). 2015;11:851–64.\nStones RW, Mountfield J. Interventions for treating chronic pelvic pain in women. Cochrane Database Syst Rev. 2000; CD000387.\nRose MA, Kam PC. Gabapentin: pharmacology and its use in pain management. Anaesthesia. 2002;57:451–62.\nMontastruc F, Loo SY, Renoux C. Trends in First Gabapentin and Pregabalin Prescriptions in Primary Care in the United Kingdom, 1993–2017. JAMA. 2018;320:2149–51.\nWiffen PJ, Derry S, Bell RF, Rice AS, Tölle TR, Phillips T, et al. Gabapentin for chronic neuropathic pain in adults. Cochrane Database Syst Rev. 2017;6:CD007938.\nAbdi S, Lee DH, Chung JM. The anti-allodynic effects of amitriptyline, gabapentin, and lidocaine in a rat model of neuropathic pain. Anesth Analg. 1998;87:1360–6.\nIannetti GD, Zambreanu L, Wise RG, Buchanan TJ, Huggins JP, Smart TS, et al. Pharmacological modulation of pain-related brain activity during normal and central sensitization states in humans. Proc Natl Acad Sci U S A. 2005;102:18195–200.\nPan HL, Eisenach JC, Chen SR. Gabapentin suppresses ectopic nerve discharges and reverses allodynia in neuropathic rats. J Pharmacol Exp Ther. 1999;288:1026–30.\nSator-Katzenschlager SM, Scharbert G, Kress HG, Frickey N, Ellend A, Gleiss A, et al. Chronic pelvic pain treated with gabapentin and amitriptyline: a randomized controlled pilot study. Wien Klin Wochenschr. 2005;117:761–8.\nHorne AW, Vincent K, Hewitt CA, Middleton LJ, Koscielniak M, Szubert W, et al. Gabapentin for chronic pelvic pain in women (GaPP2): a multicentre, randomised, double-blind, placebo-controlled trial. Lancet. 2020;396:909–17.\nAbdelHafeez MA, Reda A, Elnaggar A, El-Zeneiny H, Mokhles JM. Gabapentin for the management of chronic pelvic pain in women. Arch Gynecol Obstet. 2019;300:1271–7.\nLewis SC, Bhattacharya S, Wu O, Vincent K, Jack SA, Critchley HO, et al. Gabapentin for the management of chronic pelvic pain in women (GaPP1): a pilot randomised controlled trial. PLoS One. 2016;11:e0153037.\nSeretny M, Murray SR, Whitaker L, Murnane J, Whalley H, Pernet C, et al. The use of brain functional magnetic resonance imaging to determine the mechanism of action of gabapentin in managing chronic pelvic pain in women: a pilot study. BMJ Open. 2019;9:e026152.\nBachmann GA, Brown CS, Phillips NA, et al. Effect of gabapentin on sexual function in vulvodynia: a randomized, placebo-controlled trial. Am J Obstet Gynecol. 2019;220:89.e1–8.\nMagistro G, Wagenlehner FM, Grabe M, Weidner W, Stief CG, Nickel JC. Contemporary management of chronic prostatitis/chronic pelvic pain syndrome. Eur Urol. 2016;69:286–97.\nAlexander RB, Propert KJ, Schaeffer AJ, Landis JR, Nickel JC, O'Leary MP, et al. Ciprofloxacin or tamsulosin in men with chronic prostatitis/chronic pelvic pain syndrome: a randomized, double-blind trial. Ann Intern Med. 2004;141:581–9.\nAnothaisintawee T, Attia J, Nickel JC, Thammakraisorn S, Numthavaj P, McEvoy M, et al. Management of chronic prostatitis/chronic pelvic pain syndrome: a systematic review and network meta-analysis. JAMA. 2011;305:78–86.\nNickel JC, Downey J, Clark J, Casey RW, Pommerville PJ, Barkin J, et al. Levofloxacin for chronic prostatitis/chronic pelvic pain syndrome in men: a randomized placebo-controlled multicenter trial. Urology. 2003;62:614–7.\nDallocchio C, Buffa C, Mazzarello P, Chiroli S. Gabapentin vs. amitriptyline in painful diabetic neuropathy: an open-label pilot study. J Pain Symptom Manage. 2000;20:280–5.\nKeskinbora K, Pekel AF, Aydinli I. Comparison of efficacy of gabapentin and amitriptyline in the management of peripheral neuropathic pain. Agri. 2006;18:34–40.\nPoterucha TJ, Murphy SL, Rho RH, Sandroni P, Warndahl RA, Weiss WT, et al. Topical amitriptyline-ketamine for treatment of rectal, genital, and perineal pain and discomfort. Pain Physician. 2012;15:485–8.\nCakici ÖU, Hamidi N, Ürer E, Okulu E, Kayigil O. Efficacy of sertraline and gabapentin in the treatment of urethral pain syndrome: retrospective results of a single institutional cohort. Cent European J Urol. 2018;71:78–83.\nStrauss AC, Dimitrakov JD. New treatments for chronic prostatitis/chronic pelvic pain syndrome. Nat Rev Urol. 2010;7:127–35.\nNguyen S, Harleman E. I have chronic pelvic pain: what should I know? JAMA Intern Med. 2021;181:888.\nHewitt CA, Vincent K, Middleton LJ, Romaniuk L, Koscielniak M, Doust AM, et al. Efficacy and Mechanism Evaluation. Gabapentin to reduce pain in women aged between 18 and 50 years with chronic pelvic pain: the GaPP2 RCT. Southampton (UK): NIHR Journals Library Copyright © Queen’s Printer and Controller of HMSO 2020. This work was produced by Hewitt et al. under the terms of a commissioning contract issued by the Secretary of State for Health and Social Care. This issue may be freely reproduced for the purposes of private research and study and extracts (or indeed, the full report) may be included in professional journals provided that suitable acknowledgement is made and the reproduction is not associated with any form of advertising. Applications for commercial reproduction should be addressed to: NIHR Journals Library, National Institute for Health Research, Evaluation, Trials and Studies Coordinating Centre, Alpha House, University of Southampton Science Park, Southampton SO16 7NS, UK.; 2020.\nMcLean MJ, Morrell MJ, Willmore LJ, Privitera MD, Faught RE, Holmes GL, et al. Safety and tolerability of gabapentin as adjunctive therapy in a large, multicenter study. Epilepsia. 1999;40:965–72.\nBeydoun A, Uthman BM, Sackellares JC. Gabapentin: pharmacokinetics, efficacy, and safety. Clin Neuropharmacol. 1995;18:469–81.\nAuthor information\nAuthors and Affiliations\nContributions\nY.W.H. helped to design the study, conduct the study, analyze the data, and write the manuscript. Y.W.H. is also the first author and is responsible for archiving the study files. X.H.Z. helped to conduct the study, analyze the data, and write the manuscript. W.H.M. is the corresponding author, mainly responsible for the inspection of the study, and final approval of the article.\nCorresponding author\nEthics declarations\nConflicts of interest\nThis article did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.\nAdditional information\nPublisher’s note\nSpringer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.\nSupplementary information\nESM 1 (download DOCX )\n(DOCX 16 kb)\nESM 2 (download DOCX )\n(DOCX 32 kb)\nRights and permissions\nAbout this article\nCite this article\nHe, Y., Zhuang, X. & Ma, W. Is gabapentin effective and safe in the treatment of chronic pelvic pain in women: a systematic review and meta-analysis. Int Urogynecol J 33, 1071–1081 (2022). https://doi.org/10.1007/s00192-021-05017-0\nReceived:\nAccepted:\nPublished:\nVersion of record:\nIssue date:\nDOI: https://doi.org/10.1007/s00192-021-05017-0","source_license":"CC0","license_restricted":false}