Treatments Vary in Trigeminal Neuralgia

An examination of treatment patterns among patients with trigeminal neuralgia suggests that this orofacial disorder appears to be significantly burdensome. Findings from this study were published in The Clinical Journal of Pain.

In order to characterize treatment utilization patterns, researchers used the US Truven Health MarketScan database to identify patients ≥18 years old newly diagnosed with trigeminal neuralgia. They examined the use of pharmacologic treatments such as carbamazepine and oxcarbazepine (both recommended as first-line therapies), pregabalin, gabapentin, baclofen, duloxetine, and topiramate. The use of surgery (posterior fossa, radiosurgery), and injections (peripheral anesthetic injections, Gasserian ganglion procedures) was also assessed.

A total of 3685 patients were included for analysis. The data showed 72.5% of patients received ≥1 of the evaluated drugs with carbamazepine (51.7%) and gabapentin (48.6%) being the most commonly prescribed. More than half of the patients who received pharmacotherapy had at least 2 treatment episodes (65%), and 41.6% of patients had at least 3 treatment episodes (defined by a change in drug regimen). Opioids were prescribed to 42.9% of patients; 12.3% of patients had surgery and 7.3% received injections.

“A high proportion of pharmacologically treated patients receive multiple treatment episodes, suggesting frequent therapy switching, perhaps due to suboptimal efficacy/tolerability,” the authors write. “Our data suggest a high burden of illness associated with [trigeminal neuralgia].”

Reference

Zakrzewska JM, Wu N, Lee JYK, Werneburg B, Hoffman D, Liu Y. Characterizing treatment utilization patterns for trigeminal neuralgia in the United States [published online February 13, 2018]. Clin J Pain. doi:10.1097/AJP.0000000000000595

This article originally appeared on MPR