Extracorporeal Treatment for Gabapentin and Pregabalin Poisoning : Systematic Review and Recommendations From the EXTRIP Workgroup
Copyright © 2021 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved..
Toxicity from gabapentin and pregabalin overdose is commonly encountered. Treatment is supportive, and the use of extracorporeal treatments (ECTRs) is controversial. The EXTRIP workgroup conducted systematic reviews of the literature and summarized findings following published methods. Thirty-three articles (30 patient reports and 3 pharmacokinetic studies) met the inclusion criteria. High gabapentinoid extracorporeal clearance (>150mL/min) and short elimination half-life (<5 hours) were reported with hemodialysis. The workgroup assessed gabapentin and pregabalin as "dialyzable" for patients with decreased kidney function (quality of the evidence grade as A and B, respectively). Limited clinical data were available (24 patients with gabapentin toxicity and 7 with pregabalin toxicity received ECTR). Severe toxicity, mortality, and sequelae were rare in cases receiving ECTR and in historical controls receiving standard care alone. No clear clinical benefit from ECTR could be identified although major knowledge gaps were acknowledged, as well as costs and harms of ECTR. The EXTRIP workgroup suggests against performing ECTR in addition to standard care rather than standard care alone (weak recommendation, very low quality of evidence) for gabapentinoid poisoning in patients with normal kidney function. If decreased kidney function and coma requiring mechanical ventilation are present, the workgroup suggests performing ECTR in addition to standard care (weak recommendation, very low quality of evidence).
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2022 |
|---|---|
| Erschienen: |
2022 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:79 |
|---|---|
| Enthalten in: |
American journal of kidney diseases : the official journal of the National Kidney Foundation - 79(2022), 1 vom: 30. Jan., Seite 88-104 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Bouchard, Josée [VerfasserIn] |
|---|
| Links: |
|---|
| Anmerkungen: |
Date Completed 02.02.2022 Date Revised 02.02.2022 published: Print-Electronic Citation Status MEDLINE |
|---|
| doi: |
10.1053/j.ajkd.2021.06.027 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM333364988 |
|---|
| LEADER | 01000naa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM333364988 | ||
| 003 | DE-627 | ||
| 005 | 20231225221521.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 231225s2022 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1053/j.ajkd.2021.06.027 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1111.xml |
| 035 | |a (DE-627)NLM333364988 | ||
| 035 | |a (NLM)34799138 | ||
| 035 | |a (PII)S0272-6386(21)00791-5 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Bouchard, Josée |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Extracorporeal Treatment for Gabapentin and Pregabalin Poisoning |b Systematic Review and Recommendations From the EXTRIP Workgroup |
| 264 | 1 | |c 2022 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 02.02.2022 | ||
| 500 | |a Date Revised 02.02.2022 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2021 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved. | ||
| 520 | |a Toxicity from gabapentin and pregabalin overdose is commonly encountered. Treatment is supportive, and the use of extracorporeal treatments (ECTRs) is controversial. The EXTRIP workgroup conducted systematic reviews of the literature and summarized findings following published methods. Thirty-three articles (30 patient reports and 3 pharmacokinetic studies) met the inclusion criteria. High gabapentinoid extracorporeal clearance (>150mL/min) and short elimination half-life (<5 hours) were reported with hemodialysis. The workgroup assessed gabapentin and pregabalin as "dialyzable" for patients with decreased kidney function (quality of the evidence grade as A and B, respectively). Limited clinical data were available (24 patients with gabapentin toxicity and 7 with pregabalin toxicity received ECTR). Severe toxicity, mortality, and sequelae were rare in cases receiving ECTR and in historical controls receiving standard care alone. No clear clinical benefit from ECTR could be identified although major knowledge gaps were acknowledged, as well as costs and harms of ECTR. The EXTRIP workgroup suggests against performing ECTR in addition to standard care rather than standard care alone (weak recommendation, very low quality of evidence) for gabapentinoid poisoning in patients with normal kidney function. If decreased kidney function and coma requiring mechanical ventilation are present, the workgroup suggests performing ECTR in addition to standard care (weak recommendation, very low quality of evidence) | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Research Support, Non-U.S. Gov't | |
| 650 | 4 | |a Systematic Review | |
| 650 | 4 | |a Clinical practice recommendations | |
| 650 | 4 | |a dialyzability | |
| 650 | 4 | |a extracorporeal clearance | |
| 650 | 4 | |a gabapentin | |
| 650 | 4 | |a gabapentinoids | |
| 650 | 4 | |a hemodialysis | |
| 650 | 4 | |a hemoperfusion | |
| 650 | 4 | |a intoxication | |
| 650 | 4 | |a kidney function | |
| 650 | 4 | |a neuropathic pain | |
| 650 | 4 | |a overdose | |
| 650 | 4 | |a poisoning | |
| 650 | 4 | |a pregabalin | |
| 650 | 4 | |a renal clearance | |
| 650 | 4 | |a substance abuse | |
| 650 | 4 | |a systematic review | |
| 650 | 4 | |a toxicokinetics | |
| 650 | 7 | |a Pregabalin |2 NLM | |
| 650 | 7 | |a 55JG375S6M |2 NLM | |
| 650 | 7 | |a Gabapentin |2 NLM | |
| 650 | 7 | |a 6CW7F3G59X |2 NLM | |
| 700 | 1 | |a Yates, Christopher |e verfasserin |4 aut | |
| 700 | 1 | |a Calello, Diane P |e verfasserin |4 aut | |
| 700 | 1 | |a Gosselin, Sophie |e verfasserin |4 aut | |
| 700 | 1 | |a Roberts, Darren M |e verfasserin |4 aut | |
| 700 | 1 | |a Lavergne, Valéry |e verfasserin |4 aut | |
| 700 | 1 | |a Hoffman, Robert S |e verfasserin |4 aut | |
| 700 | 1 | |a Ostermann, Marlies |e verfasserin |4 aut | |
| 700 | 1 | |a Peng, Ai |e verfasserin |4 aut | |
| 700 | 1 | |a Ghannoum, Marc |e verfasserin |4 aut | |
| 700 | 0 | |a EXTRIP Workgroup |e verfasserin |4 aut | |
| 700 | 1 | |a Alhatali, Badria |e investigator |4 oth | |
| 700 | 1 | |a Anseeuw, Kurt |e investigator |4 oth | |
| 700 | 1 | |a Bird, Steven |e investigator |4 oth | |
| 700 | 1 | |a Berling, Ingrid |e investigator |4 oth | |
| 700 | 1 | |a Bunchman, Timothy E |e investigator |4 oth | |
| 700 | 1 | |a Chin, Paul K |e investigator |4 oth | |
| 700 | 1 | |a Doi, Kent |e investigator |4 oth | |
| 700 | 1 | |a Galvao, Tais |e investigator |4 oth | |
| 700 | 1 | |a Goldfarb, David S |e investigator |4 oth | |
| 700 | 1 | |a Hassanian, Hossein |e investigator |4 oth | |
| 700 | 1 | |a Hoegberg, Lotte C G |e investigator |4 oth | |
| 700 | 1 | |a Kallab, Siba |e investigator |4 oth | |
| 700 | 1 | |a Kebede, Sofia |e investigator |4 oth | |
| 700 | 1 | |a Kielstein, Jan T |e investigator |4 oth | |
| 700 | 1 | |a Lewington, Andrew |e investigator |4 oth | |
| 700 | 1 | |a Macedo, Etienne M |e investigator |4 oth | |
| 700 | 1 | |a MacLaren, Rob |e investigator |4 oth | |
| 700 | 1 | |a Megarbane, Bruno |e investigator |4 oth | |
| 700 | 1 | |a Mowry, James B |e investigator |4 oth | |
| 700 | 1 | |a Nolin, Thomas D |e investigator |4 oth | |
| 700 | 1 | |a Roy, Jean-Philippe |e investigator |4 oth | |
| 700 | 1 | |a Vijayan, Anitha |e investigator |4 oth | |
| 700 | 1 | |a Walsh, Steven J |e investigator |4 oth | |
| 700 | 1 | |a Wong, Anselm |e investigator |4 oth | |
| 700 | 1 | |a Wood, David M |e investigator |4 oth | |
| 773 | 0 | 8 | |i Enthalten in |t American journal of kidney diseases : the official journal of the National Kidney Foundation |d 1982 |g 79(2022), 1 vom: 30. Jan., Seite 88-104 |w (DE-627)NLM012600814 |x 1523-6838 |7 nnns |
| 773 | 1 | 8 | |g volume:79 |g year:2022 |g number:1 |g day:30 |g month:01 |g pages:88-104 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1053/j.ajkd.2021.06.027 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 79 |j 2022 |e 1 |b 30 |c 01 |h 88-104 | ||