Pregabalin vs. gabapentin in the treatment of neuropathic pain: a comprehensive systematic review and meta-analysis of effectiveness and safety
IntroductionNeuropathic pain is a prevalent and burdensome condition, and both pregabalin and gabapentin are widely used for its treatment. However, there is a lack of clarity regarding their comparative efficacy and safety. This meta-analysis aims to evaluate and compare the effectiveness and safet...
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Frontiers Media S.A.
2025-01-01
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| Series: | Frontiers in Pain Research |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fpain.2024.1513597/full |
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| author | Víctor Mayoral Rafael Galvez Marta Ferrándiz Xoán Miguéns Vázquez Carlos Cordero-García Antonio Alcántara Montero Concepción Pérez María Pérez-Páramo |
| author_facet | Víctor Mayoral Rafael Galvez Marta Ferrándiz Xoán Miguéns Vázquez Carlos Cordero-García Antonio Alcántara Montero Concepción Pérez María Pérez-Páramo |
| author_sort | Víctor Mayoral |
| collection | DOAJ |
| description | IntroductionNeuropathic pain is a prevalent and burdensome condition, and both pregabalin and gabapentin are widely used for its treatment. However, there is a lack of clarity regarding their comparative efficacy and safety. This meta-analysis aims to evaluate and compare the effectiveness and safety of pregabalin vs. gabapentin in managing neuropathic pain.MethodsThis study followed PRISMA guidelines and employed the PICOS search strategy. Comparative studies (clinical trials and cohort studies) were included, with patients with neuropathic pain treated either with pregabalin or gabapentin. Primary outcomes assessed were efficacy and safety. Data were extracted from PubMed, Embase, Scopus, and the Cochrane Collaboration Library databases. The risk of bias was evaluated using the Cochrane Review Manager tool. Statistical analysis was performed using Review Manager 5.4.1 software, calculating effect sizes and conducting sensitivity analysis based on medication dosage.ResultsA total of 14 studies with 3,346 patients were analyzed. Pregabalin showed superior results compared to gabapentin in the Visual Analog Scale (VAS) at various time intervals up to 12–14 weeks (SMD −0.47, 95% CI −0.74 to −0.19). The pregabalin group also had significant improvements in SF-12/SF-36/EQ-5D scores (SMD 0.39, 95% CI 0.11–0.68) and experienced more days with no/mild pain (MD 9.00, 95% CI 8.93–9.07) and fewer days with severe pain (MD −3.00, 95% CI −4.96 to −1.04). Pregabalin resulted in lower opioid consumption (OR 0.50, 95% CI 0.33–0.76). Gabapentin had a higher incidence of nausea and vomiting. Sensitivity analysis supported the efficacy of pregabalin.ConclusionIn conclusion, pregabalin demonstrated superior and faster efficacy in alleviating neuropathic pain than gabapentin did. Additionally, it improved patient-reported outcomes, resulted in lower opioid consumption, and led to fewer adverse events.Systematic Review Registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?RecordID=565208, PROSPERO (CRD42024565208). |
| format | Article |
| id | doaj-art-c8e4c070df8145a092b469516970f830 |
| institution | Kabale University |
| issn | 2673-561X |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Frontiers Media S.A. |
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| series | Frontiers in Pain Research |
| spelling | doaj-art-c8e4c070df8145a092b469516970f8302025-01-07T06:41:17ZengFrontiers Media S.A.Frontiers in Pain Research2673-561X2025-01-01510.3389/fpain.2024.15135971513597Pregabalin vs. gabapentin in the treatment of neuropathic pain: a comprehensive systematic review and meta-analysis of effectiveness and safetyVíctor Mayoral0Rafael Galvez1Marta Ferrándiz2Xoán Miguéns Vázquez3Carlos Cordero-García4Antonio Alcántara Montero5Concepción Pérez6María Pérez-Páramo7Pain Unit, Anaesthesiology Department, Hospital Universitari de Bellvitge, Barcelona, SpainPain Unit, Deparment of Anesthesia, Hospital Virgen de las Nieves, Granada, SpainPain Unit, Hospital Universitari de La Santa Creu I Sant Pau, Barcelona, SpainDepartment of Physical Medicine and Rehabilitation, Área Sanitaria de Ourense, Verin e O Barco de Valdeorras, Ourense, SpainDepartment of Physical Medicine and Rehabilitation, Juan Ramón Jiménez University Hospital, Huelva, SpainCentro de Salud Trujillo, Cáceres, SpainPain Unit, Hospital de la Princesa, Madrid, SpainMedical Department, Viatris, Madrid, SpainIntroductionNeuropathic pain is a prevalent and burdensome condition, and both pregabalin and gabapentin are widely used for its treatment. However, there is a lack of clarity regarding their comparative efficacy and safety. This meta-analysis aims to evaluate and compare the effectiveness and safety of pregabalin vs. gabapentin in managing neuropathic pain.MethodsThis study followed PRISMA guidelines and employed the PICOS search strategy. Comparative studies (clinical trials and cohort studies) were included, with patients with neuropathic pain treated either with pregabalin or gabapentin. Primary outcomes assessed were efficacy and safety. Data were extracted from PubMed, Embase, Scopus, and the Cochrane Collaboration Library databases. The risk of bias was evaluated using the Cochrane Review Manager tool. Statistical analysis was performed using Review Manager 5.4.1 software, calculating effect sizes and conducting sensitivity analysis based on medication dosage.ResultsA total of 14 studies with 3,346 patients were analyzed. Pregabalin showed superior results compared to gabapentin in the Visual Analog Scale (VAS) at various time intervals up to 12–14 weeks (SMD −0.47, 95% CI −0.74 to −0.19). The pregabalin group also had significant improvements in SF-12/SF-36/EQ-5D scores (SMD 0.39, 95% CI 0.11–0.68) and experienced more days with no/mild pain (MD 9.00, 95% CI 8.93–9.07) and fewer days with severe pain (MD −3.00, 95% CI −4.96 to −1.04). Pregabalin resulted in lower opioid consumption (OR 0.50, 95% CI 0.33–0.76). Gabapentin had a higher incidence of nausea and vomiting. Sensitivity analysis supported the efficacy of pregabalin.ConclusionIn conclusion, pregabalin demonstrated superior and faster efficacy in alleviating neuropathic pain than gabapentin did. Additionally, it improved patient-reported outcomes, resulted in lower opioid consumption, and led to fewer adverse events.Systematic Review Registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?RecordID=565208, PROSPERO (CRD42024565208).https://www.frontiersin.org/articles/10.3389/fpain.2024.1513597/fullpregabalingabapentinneuropathic painpainmeta-analysissystematic review |
| spellingShingle | Víctor Mayoral Rafael Galvez Marta Ferrándiz Xoán Miguéns Vázquez Carlos Cordero-García Antonio Alcántara Montero Concepción Pérez María Pérez-Páramo Pregabalin vs. gabapentin in the treatment of neuropathic pain: a comprehensive systematic review and meta-analysis of effectiveness and safety Frontiers in Pain Research pregabalin gabapentin neuropathic pain pain meta-analysis systematic review |
| title | Pregabalin vs. gabapentin in the treatment of neuropathic pain: a comprehensive systematic review and meta-analysis of effectiveness and safety |
| title_full | Pregabalin vs. gabapentin in the treatment of neuropathic pain: a comprehensive systematic review and meta-analysis of effectiveness and safety |
| title_fullStr | Pregabalin vs. gabapentin in the treatment of neuropathic pain: a comprehensive systematic review and meta-analysis of effectiveness and safety |
| title_full_unstemmed | Pregabalin vs. gabapentin in the treatment of neuropathic pain: a comprehensive systematic review and meta-analysis of effectiveness and safety |
| title_short | Pregabalin vs. gabapentin in the treatment of neuropathic pain: a comprehensive systematic review and meta-analysis of effectiveness and safety |
| title_sort | pregabalin vs gabapentin in the treatment of neuropathic pain a comprehensive systematic review and meta analysis of effectiveness and safety |
| topic | pregabalin gabapentin neuropathic pain pain meta-analysis systematic review |
| url | https://www.frontiersin.org/articles/10.3389/fpain.2024.1513597/full |
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