Pregabalin analysis shows the anticonvulsants medication reduces pain and improves sleep interference, but also that it increases adverse event risk in post-traumatic peripheral neuropathic pain (PTNP), according to a publication in Pain Practice.
Investigators from centers in Iran searched publication databases through January 2022 for randomized clinical trials evaluating pregabalin use in the setting of PTNP. A total of 3 double-blind, randomized, controlled trials published in 2010, 2012, and 2018 were included in this analysis.
The pooled sample size included 821 patients. Stratified by study, 13, 127, and 275 received 150-600 mg pregabalin per day and 12, 127, and 267 received placebo for 7 to 15 weeks.
In the efficacy, the pregabalin analysis shows the drug is associated with reduced pain (standardized mean difference [SMD], -0.14; 95% CI, 0.28 to -0.006; P =.04) and improved sleep (mean difference [MD], -0.25; 95% CI, -0.39 to -0.11; P =0.00) compared with placebo.
In the safety, the pregabalin analysis shows it is associated with increased reports of dizziness (risk ratio [RR], 4.13; 95% CI, 2.71-6.28; P =0.00), disturbed attention (RR, 2.97; 95% CI, 1.02-8.65; P =.04), and somnolence (RR, 2.78; 95% CI, 1.64-4.71; P =.00) compared with placebo. Pregabalin was not associated with increased risk for headache (RR, 1.20; 95% CI, 0.70-2.06; P =.50), fatigue (RR, 1.42; 95% CI, 0.82.2.47; P =.20), nausea (RR, 1.52; 95% CI, 0.88-2.62; P =.13), constipation (RR, 1.84; 95% CI, 0.78-4.29; P =.15), or discontinuation (RR, 1.52; 95% CI, 0.45-5.06; P =.49) relative to placebo.
In a sensitivity, pregabalin analysis, the research team compared outcomes in fixed and random effects models, with findings largely consistent with the main analysis.
The major limitation of this study was the few relevant studies and the fact that 1 study had a small sample size.
This analysis found that pregabalin may be effective for the treatment of PTNP but with risk for some adverse events.
“The present meta-analysis findings showed pregabalin was statistically significantly superior to placebo in reducing PTNP and improving the sleep quality in patients with PTNP,” the researchers explain. However, the same pregabalin analysis shows it can increase the risk of dizziness and disturbance in attention compared with placebo.”
This article originally appeared on Clinical Pain Advisor
Maleki MS, Zamani Z, Amiri R, et al. Pregabalin in patients with post-traumatic peripheral neuropathic pain: a meta-analysis of randomized controlled trials. Pain Pract. Published online March 13, 2023. doi:10.1111/papr.13221