Pregabalin shows mixed effect on chronic pain after nerve injury

  • Markman J & al.
  • J Neurol
  • 21 Sep 2018

  • curated by Susan London
  • Clinical Essentials
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Takeaway

  • Among patients with posttraumatic peripheral neuropathic pain due to varied causes, pregabalin (Lyrica) was similar to placebo on change in mean pain score but superior for reducing pain severity and sleep interference.

Why this matters

Key results

  • Change in mean pain score on 10-point scale was −2.12 points with pregabalin and −1.90 points with placebo (mean difference, –0.22 points; P=.1823).
  • However, mean differences in secondary outcomes better with pregabalin:
    • Week 1-15 overall mean pain effect (−0.31; P=.0117);
    • Sleep interference at week 15 (−0.43; P=.0031);
    • Endpoint Brief Pain Inventory, pain severity (−0.46; P=.0050);
    • Endpoint Brief Pain Inventory, pain interference (−0.38; P=.0168).
  • Most common adverse events with pregabalin:
    • Dizziness (14.6% vs 4.2%);
    • Somnolence (9.9% vs 3.4%).

Study design

  • Randomized controlled trial among 542 adult patients with posttraumatic peripheral neuropathic pain (49.6% related to surgery) at 101 centers in 11 countries.
  • Randomization: double-blind pregabalin (flexibly dosed 150-600 mg/day) vs matching placebo.
  • Main outcome: 15-week change in mean pain score.
  • Funding: Pfizer Inc.

Limitations

  • Heterogeneous population.
  • Analytic methodology possibly limiting sensitivity for differences.
  • Patient dropout.

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