Efficacy of opioids in combination with gabapentin vs. opioids alone in the treatment of patients with cancer‑related pain due to bone metastases from malignant neoplasms: A meta‑analysis

Cancer pain seriously affects the quality of life of patients with malignant tumors, especially the pain caused by bone metastases. In recent years, gabapentin has demonstrated potential value in the treatment of cancer pain from bone metastases, providing promising new ideas for clinical treatment. The aim of the present study was to systematically evaluate the efficacy of opioids combined with gabapentin compared with opioids alone in the treatment of cancer-related pain due to bone metastases of malignant tumors based on meta-analysis. PubMed, Embase, Web of Science, China National Knowledge Infrastructure, VIP, Wanfang Data and other databases were searched to collect randomized controlled trials and non-randomized controlled trials of opioids combined with gabapentin compared with opioids alone for the treatment of cancer pain due to malignant bone metastases. The quality of the included studies was evaluated using the Cochrane Risk of Bias Assessment 2.0 tool and the Newcastle-Ottawa Scale. Subsequent meta-analyses were performed using the R language. A total of 25 studies including 1,805 patients were included. Meta-analysis results showed that gabapentin in combination with opioids exhibited a notable advantage in reducing pain scores compared with opioids alone (mean difference=1.26; 95% CI, 0.88-1.65). Subgroup analyses by study type, sample size and treatment regimen revealed that heterogeneity was influenced by a number of factors. Sensitivity analyses demonstrated the robustness of the findings. However, limited data on adverse effects precluded comprehensive safety analysis. Gabapentin in combination with opioids may be an effective regimen for the treatment of cancer-related pain associated with bone metastases from malignant tumors. However, due to the heterogeneity of the included studies and limited safety data, clinical application requires caution and individualized treatment regimens based on patient-specific conditions.