Pregabalin: Can Concomitant Neuropathic Pain Medications Affect Efficacy?

The therapeutic efficacy of pregabalin in treating 2 types of neuropathic pain (NeP) is not influenced by concomitant NeP medications, according to new research published in the journal Pain Physician.

The authors carried out a retrospective analysis of 9 randomized placebo-controlled trials (7 focused on treating postherpetic neuralgia (PHN) and 2 on spinal cord injury (SPI-NeP)). Patients rated the severity of their pain and pain-related sleep interference (PRSI) for each day of treatment. Adverse events and concomitant drug use were noted.

Trial participants received pregabalin doses of 150mg, 300mg, 600mg, and flexible 150 – 600mg/d. Results showed that pregabalin significantly improved pain and PRSI scores compared to placebo at most dose levels and time points examined.

Patients who received concomitant NeP medications showed little difference in therapeutic response in comparison to those who received pregabalin alone. In addition, adverse events were unaffected by concomitant NeP medications. The authors asserted that their findings show there was no ‘floor effect’ present, meaning the use of other medications did not mask the effects of pregabalin.

The implications of the findings suggest that physicians may keep patients on their current NeP medications when introducing pregabalin to the treatment regimen, since the response to pregabalin is not diminished by concomitant NeP medications.

The authors also acknowledged the limitation of their analysis in that the original trials did not seek to examine the effects of concomitant NeP medications. 

Reference

Schug SA, Parsons B, Almas M, Whalen E. Effect of concomitant pain medications on response to pregabalin in patients with postherpetic neuralgia or spinal cord injury-related neuropathic pain [published online January 2017]. Pain Physician. 

This article originally appeared on MPR