Comparing the Effectiveness of Pregabalin and Gabapentin in Patients with Lumbar Radiculopathy: A Systematic Review and Meta-analysis

Overview

Journal Pain Pract

Specialties Neurology
Psychiatry

Date 2024 Oct 12

PMID 39394725

Authors

Do Yun Kwon

Kwang-Ryeol Kim

Dong Hyuck Kim

Sang Gyu Kwak

Affiliations

Soon will be listed here.

Abstract

Background: Gabapentinoids are commonly prescribed to control neuropathic pain of lumbar radiculopathy. Few trials have compared the efficacy of gabapentin (GBP) and pregabalin (PGB). Therefore, the authors conducted a meta-analysis to compare the difference in effect between GBP and PGB in lumbar radiculopathy patients.

Methods: Articles which were published between January 1, 1960 and May 31, 2023 were investigated via Cochrane Central Register of Controlled Trials, Embase, Google Scholar, and MEDLINE. This meta-analysis was conducted on patients with lumbar radiculopathy. Gabapentin was used as an intervention, and pregabalin as a comparison. As outcomes, pain rating scales including visual analog scale (VAS) and numeric pain rating scale (NRS), and number of adverse events (dizziness and sedation) were obtained.

Results: PGB showed statistically significant improvement in pain scale (VAS and NRS) in short-term follow-up (6 weeks or less) compared to GBP. (Total mean difference of -0.31) However, in the long-term follow-up (6 weeks to 12 weeks), there was no difference in pain reduction effect between two groups. The incidence of AEs showed no difference between two groups.

Conclusion: Based on this article, the existing evidence suggests that PGB was more effective in reducing pain of lumbar radiculopathy compared to GBP at the short-term follow-up, but there was no difference in the long-term follow-up. Physicians should consider this finding in prescribing medications for patients with lumbar radiculopathy.

Citing Articles

Comparing the effectiveness of pregabalin and gabapentin in patients with lumbar radiculopathy: A systematic review and meta-analysis.

Kwon D, Kim K, Kim D, Kwak S Pain Pract. 2024; .

PMID: 39394725 PMC: 11683178. DOI: 10.1111/papr.13424.

References

Sills G . The mechanisms of action of gabapentin and pregabalin. Curr Opin Pharmacol. 2005; 6(1):108-13. DOI: 10.1016/j.coph.2005.11.003. View

Brozek J, Akl E, Compalati E, Kreis J, Terracciano L, Fiocchi A . Grading quality of evidence and strength of recommendations in clinical practice guidelines part 3 of 3. The GRADE approach to developing recommendations. Allergy. 2011; 66(5):588-95. DOI: 10.1111/j.1398-9995.2010.02530.x. View

Kwak S, Kwon J, Seo Y, Choi W . The effectiveness of acupuncture as an adjunctive therapy to oral pharmacological medication in patient with knee osteoarthritis: A systematic review and meta-analysis. Medicine (Baltimore). 2023; 102(11):e33262. PMC: 10019238. DOI: 10.1097/MD.0000000000033262. View

Wallin J, Cui J, Yakhnitsa V, Schechtmann G, Meyerson B, Linderoth B . Gabapentin and pregabalin suppress tactile allodynia and potentiate spinal cord stimulation in a model of neuropathy. Eur J Pain. 2002; 6(4):261-72. DOI: 10.1053/eujp.2002.0329. View

Gammoh O, Al-Smadi A, Shawagfeh M, Abadi T, Kasawneh J, Malkawi S . The Clinical Difference between Gabapentin and Pregabalin: Data from a Pilot Comparative Trial. Rev Recent Clin Trials. 2021; 16(3):279-287. DOI: 10.2174/1574887116666210201110507. View

Brozek J, Akl E, Alonso-Coello P, Lang D, Jaeschke R, Williams J . Grading quality of evidence and strength of recommendations in clinical practice guidelines. Part 1 of 3. An overview of the GRADE approach and grading quality of evidence about interventions. Allergy. 2009; 64(5):669-77. DOI: 10.1111/j.1398-9995.2009.01973.x. View

Guay D . Pregabalin in neuropathic pain: a more "pharmaceutically elegant" gabapentin?. Am J Geriatr Pharmacother. 2006; 3(4):274-87. View

Gimenez-Campos M, Pimenta-Fermisson-Ramos P, Diaz-Cambronero J, Carbonell-Sanchis R, Lopez-Briz E, Ruiz-Garcia V . A systematic review and meta-analysis of the effectiveness and adverse events of gabapentin and pregabalin for sciatica pain. Aten Primaria. 2021; 54(1):102144. PMC: 8515246. DOI: 10.1016/j.aprim.2021.102144. View

Berry J, Elia C, Saini H, Miulli D . A Review of Lumbar Radiculopathy, Diagnosis, and Treatment. Cureus. 2019; 11(10):e5934. PMC: 6858271. DOI: 10.7759/cureus.5934. View

10.

Ye W, Hackett S, Vandevelde C, Twigg S, Helliwell P, Coates L . Comparing the Visual Analog Scale and the Numerical Rating Scale in Patient-reported Outcomes in Psoriatic Arthritis. J Rheumatol. 2020; 48(6):836-840. DOI: 10.3899/jrheum.200928. View

11.

Tzellos T, Papazisis G, Toulis K, Sardeli C, Kouvelas D . A2delta ligands gabapentin and pregabalin: future implications in daily clinical practice. Hippokratia. 2010; 14(2):71-5. PMC: 2895293. View

12.

Bockbrader H, Wesche D, Miller R, Chapel S, Janiczek N, Burger P . A comparison of the pharmacokinetics and pharmacodynamics of pregabalin and gabapentin. Clin Pharmacokinet. 2010; 49(10):661-9. DOI: 10.2165/11536200-000000000-00000. View

13.

Dworkin R, OConnor A, Backonja M, Farrar J, Finnerup N, Jensen T . Pharmacologic management of neuropathic pain: evidence-based recommendations. Pain. 2007; 132(3):237-251. DOI: 10.1016/j.pain.2007.08.033. View

14.

Qadeer M, Waqas M, Rashid M, Enam S, Sharif S, Murtaza G . Preventive Gabapentin versus Pregabalin to Decrease Postoperative Pain after Lumbar Microdiscectomy: A Randomized Controlled Trial. Asian Spine J. 2017; 11(1):93-98. PMC: 5326739. DOI: 10.4184/asj.2017.11.1.93. View

15.

Oliveira C, Maher C, Ferreira M, Hancock M, Oliveira V, McLachlan A . Epidural corticosteroid injections for lumbosacral radicular pain. Cochrane Database Syst Rev. 2020; 4:CD013577. PMC: 7145384. DOI: 10.1002/14651858.CD013577. View

16.

Enke O, New H, New C, Mathieson S, McLachlan A, Latimer J . Anticonvulsants in the treatment of low back pain and lumbar radicular pain: a systematic review and meta-analysis. CMAJ. 2018; 190(26):E786-E793. PMC: 6028270. DOI: 10.1503/cmaj.171333. View

17.

Straube S, Derry S, McQuay H, Moore R . Enriched enrollment: definition and effects of enrichment and dose in trials of pregabalin and gabapentin in neuropathic pain. A systematic review. Br J Clin Pharmacol. 2008; 66(2):266-75. PMC: 2492925. DOI: 10.1111/j.1365-2125.2008.03200.x. View

18.

Hawker G, Mian S, Kendzerska T, French M . Measures of adult pain: Visual Analog Scale for Pain (VAS Pain), Numeric Rating Scale for Pain (NRS Pain), McGill Pain Questionnaire (MPQ), Short-Form McGill Pain Questionnaire (SF-MPQ), Chronic Pain Grade Scale (CPGS), Short Form-36 Bodily Pain.... Arthritis Care Res (Hoboken). 2012; 63 Suppl 11:S240-52. DOI: 10.1002/acr.20543. View

19.

Stefano G, Di Lionardo A, Di Pietro G, Truini A . Neuropathic Pain Related to Peripheral Neuropathies According to the IASP Grading System Criteria. Brain Sci. 2020; 11(1). PMC: 7821938. DOI: 10.3390/brainsci11010001. View

20.

Brozek J, Akl E, Jaeschke R, Lang D, Bossuyt P, Glasziou P . Grading quality of evidence and strength of recommendations in clinical practice guidelines: Part 2 of 3. The GRADE approach to grading quality of evidence about diagnostic tests and strategies. Allergy. 2009; 64(8):1109-16. DOI: 10.1111/j.1398-9995.2009.02083.x. View