Roger Chou, MD
What are the efficacy and safety of pregabalin for acute and chronic pain?
Studies selected compared pregabalin with placebo or active control in patients ≥ 18 years of age who reported pain in an acute pain setting (e.g., perioperative), were in situations that could cause acute pain, or had a chronic painful condition. Outcomes included various pain-related measures, including patient-reported pain relief ≥ 30%, and adverse events.
MEDLINE and EMBASE/Excerpta Medica (to May 2009); Cochrane Central Register of Controlled Trials (Issue 2, 2009); PhRMA clinical study results database; and reference lists were searched for double-blind, randomized controlled trials. 25 trials (n = 7652) met the selection criteria. All studies had Oxford quality scores ≥ 3 out of 5.
Pregabalin, ≥ 300 mg/d, reduced pain in patients with postherpetic neuralgia, painful diabetic neuropathy, and fibromyalgia; 600 mg/d reduced pain in patients with central neuropathic pain (Table). 6 trials of pregabalin in acute postoperative pain were too diverse to conduct a pooled analysis. Pregabalin increased risk for nonserious adverse events (e.g., somnolence and dizziness) (Table).
In adults with various types of neuropathic and chronic pain, pregabalin reduces pain but increases adverse events.
Pregabalin vs placebo in patients with chronic pain*
*Abbreviations defined in Glossary. RBI, RRI, NNT, NNH, and CI calculated from data in article using a fixed-effects model.
†Weighted event rates.
‡Corrected data provided by author.
Roger Chou. Review: Pregabalin reduces chronic neuropathic pain in adults. Ann Intern Med. 2009;151:JC6–7. doi: 10.7326/0003-4819-151-12-200912150-02007
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Published: Ann Intern Med. 2009;151(12):JC6-7.
Neurology, Neuropathy, Seizure Disorders.
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