Nitin Jain, MD, MSPH, an associate professor of physical medicine and rehabilitation at Vanderbilt University School of Medicine in Nashville, Tenn., and colleagues collected data on 63,109 U.S. patients with acute traumatic spinal cord injury. The researchers found that the number of spinal cord injuries increased from 2,659 in 1993 to 3,393 in 2012. However, the rate of injuries — the number of cases per total U.S. population — remained stable. In 1993, the rate of spinal cord injuries was 53 cases per one million people. In 2012, it was 54 cases per million.

Although the overall rate of spinal cord injury remained constant, the rate in young males between ages 16 and 24 went from 144 per million to 87 per million over the decade. In females of the same age, the researchers found the rate went from 42 per million in 1993 to 27 per million in 2012. Older men between ages 65 and 74 saw a large increase in their rate of spinal cord injuries — from 84 per million to 131 per million over the study period. The rate in women of the same age went from 32 per million to 53 per million. Among all Americans 65 and older, the number of spinal cord injury from falls increased significantly (28% in 1997-2000 to 66% in 2010-2012).

The number of deaths in hospitals from spinal cord injury increased from 6.6% in 1993-1996 to 7.5% by 2010-2012. But among those 85 and older, deaths decreased significantly. In 1993 to 1996, the death rate from spinal cord injury for older people was 24%. By 2010 to 2012, it was down to 20%.

Reference: Jain NB. JAMA. 2015; doi:10.1001/jama.2015.6250.

The FDA has approved adding use in treatment of spinal cord injury to the indications for the neuropathic pain drug pregabalin (Lyrica).

The new indication makes pregabalin the first FDA-approved treatment for neuropathic pain from spinal cord injury, according to a statement from drug maker Pfizer.

The drug is already approved to treat diabetic nerve pain, pain after shingles, fibromyalgia, and partial-onset seizures in epileptic adults taking one or more seizure drugs.

Approval for the spinal injury indication was based on two randomized, double-blind, flexibly dosed, placebo-controlled phase III studies.

A combined 357 patients were given 150 to 600 mg pregabalin daily and were allowed to take other pain medications during the trial, including NSAIDs, opioids, and non-opioids. One trial involved traumatic spinal cord injury patients, while the other included a mix of traumatic and nontraumatic injury patients, such as those who had benign spinal tumor removal.

The trials found drug treatment significantly reduced neuropathic pain from the spinal cord injuries versus placebo through the respective 12 and 16 weeks of each study, and patients taking pregabalin had a 30% to 50% reduction in pain compared with those taking placebo.

Common adverse events in the trials were somnolence, dizziness, dry mouth, fatigue, and peripheral edema.

Other adverse events seen in post-market reports include angioedema, hypersensitivity, blurred vision, weight gain, constipation, euphoric mood, balance disorder, increased appetite, and abnormal thinking and attention.

Currently, there are more than 100,000 patients in the U.S. with neuropathic pain from spinal cord injuries, and about 12,000 new spinal cord injury patients are diagnosed annually, according to Pfizer.