Grant: Doctoral Research Award: Canada Graduate Scholarships

Neuropathic pain is a debilitating condition that affects upwards of 70% of individuals with spinal cord injury (SCI), causing persistent discomfort, sleep problems, and emotional distress. Managing neuropathic pain remains a significant challenge, as conventional therapeutics often fall short. Gabapentinoids, including gabapentin and pregabalin, are two exceptions that have emerged as first-line therapeutics for neuropathic pain after SCI. Largely attributable to results of phase III prospective, randomized controlled trials that enrolled individuals with SCI, gabapentinoids now rank among the top management options for all forms neuropathic pain. Despite their prominent role in these trials, individuals with SCI have since been largely ignored in long-term, population-level, real-world effectiveness studies. These are urgently needed to validate the effectiveness and safety profile of gabapentinoids in this specific population. Our research aims to fill this crucial gap by utilizing a cohort of SCI patients extracted from PopDataBC and derived by Praxis Spinal Cord Institute to conduct a population-level, retrospective, cohort analyses to determine the long-term discontinuation rate of gabapentinoid treatment for SCI-related neuropathic pain. As secondary analyses, we will assess the occurrence of adverse events over the study period, and derive and internally validate multivariable models to identify factors significantly associated with increased likelihood of gabapentinoid cessation and adverse events. The proposed analysis of gabapentinoid treatment duration, adverse events, and influencing factors intends to inform clinical practices and refine neuropathic pain management strategies in SCI. In the absence of long-term studies, the true efficacy and safety profile of gabapentinoids remains elusive - our study aims to fill this critical gap, potentially leading to more personalized and effective pain management approaches for this specific population.