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The GaPP2 trial - a multi-centre randomised controlled trial of the efficacy of gabapentin for the management of chronic pelvic pain in women, finds the drug is ineffective.

The GaPP2 trial - a multi-centre randomised controlled trial of the efficacy of gabapentin for the management of chronic pelvic pain in women, finds the drug is ineffective. The research findings have been published in The Lancet.

Overview 

A drug that is regularly used to treat chronic pelvic pain in women has been found to be no more effective than a placebo, a new study has found. As a result, researchers recommend against routinely prescribing the drug gabapentin for women with the condition.  

Chronic pelvic pain affects as many as 24 per cent of women worldwide, including up to one million in the UK. In 55 per cent of women there is no known cause. If no underlying cause is found, the pain is much more difficult to treat.

Pain management

Gabapentin is used to manage many forms of chronic pain. In two separate surveys, 74 per cent of GPs and 90 per cent of gynaecologists said that they would consider prescribing the drug for chronic pelvic pain.

Researchers from the Universities of Edinburgh, Birmingham, Oxford (Prof Katy Vincent at the Nuffield Department of Women's & Reproductive Health) and Nottingham tested the drug’s effectiveness in treating chronic pelvic pain through a randomised clinical trial involving 306 women with the condition and no known underlying cause.

 

Testing Effectiveness

As part of the study, 153 women received gabapentin and 153 received placebo for 16 weeks. Neither group nor the prescribing clinicians knew what they were receiving.

The women were asked to rate their average pain and worst pain, using a scale from zero to ten, on a weekly basis. The scores were then averaged for the drug and placebo groups.

The team found that there was very little difference between the reported pain in both groups.

However, the group that received gabapentin reported experiencing more side-effects - including dizziness, drowsiness and changes of mood – than the placebo group.  

The researchers say that gabapentin should no longer be considered in the treatment of chronic pelvic pain where no cause has been identified, and other avenues of treatment should be explored, such as different drugs, physiotherapy and cognitive behavioural therapy.

The research findings have been published in The Lancet.  The research findings have been published in The Lancet. This work was funded through the Efficacy and Mechanism Evaluation Programme – a Medical Research Council (MRC) and the National Institute for Health Research (NIHR) partnership.

Professor Andrew Horne, lead researcher from the University of Edinburgh’s MRC Centre for Reproductive Health, said: “We have been prescribing this drug for many years with little evidence of its effectiveness. As a result of our study, we can confidently conclude that gabapentin is not effective for chronic pelvic pain in women where no cause has been identified. More research is needed to explore if other therapies can help instead.”

Read the Lancet paper here