The Use of Pregabalin for the Treatment of Peripheral and Central Neuropathic Pain in Adults (Scientific Review)

Authors

  • V.V. Marusychenko Institute of Urgent and Reconstructive Surgery named after V.K. Husak, Kyiv
  • I.A. Yevtushenko Institute of Urgent and Reconstructive Surgery named after V.K. Husak, Kyiv

DOI:

https://doi.org/10.22141/2224-0713.2.80.2016.74016

Keywords:

neuropathic pain, treatment, pregabalin

Abstract

Background. Pregabalin is a new generation gabapentinoid with improved pharmacological properties. Neuropathic pain — an actual problem of modern medicine, and in some cases it is difficult to treat. Therefore, the aim of this review was to evaluate the effectiveness of pregabalin in treating peripheral and central neuropathic pain in clinical trials of high quality. Material and methods. This review included randomized controlled trials (RCTs) with a double-blind design and their meta-analyzes. Results. The performed studies have confirmed the analgesic activity of pregabalin in patients with neuropathic pain: in painful diabetic neuropathy (9 RCTs), postherpetic neuralgia (4 RCTs), central neuropathic pain due to spinal cord injury (3 RCT), post-traumatic peripheral neuropathic pain, including chronic postoperative pain (2 RCTs), neuropathic cancer pain (2 RCTs). The effectiveness of the drug in central neuropathic pain due to brain injury and chronic low back pain (in both cases, there were 2 RCTs with «present»/«absent» effect) requires further clarification. In addition, in patients with neuropathic pain pregabalin reduced sleep interference, improved global functioning and quality of life. Also, the drug reduced the severity of allodynia in postherpetic neuralgia, anxiety in central neuropathic pain, the need for morphine in cancer neuropathic pain and the severity of related constipations, enhanced the effect of non-steroidal anti-inflammatory drugs in chronic low back pain. The effectiveness of pregabalin in elderly patients was comparable to that in younger patients. Pregabalin is administered in non-divided dose 75 mg/day or 150 mg/day in 2 divided doses. Thereafter, the dosage is gradually increased to 300–600 mg/day to achieve the optimal efficacy/safety ratio. Anesthetic effect begins to appear in the first week of treatment, depending on the dose regimen and the severity of pathology. Side effects in pregabalin treatment are mild to moderate, often disappear on their own in the course of treatment. The most common side effects were dizziness (pregabalin — 26.3 %, placebo — 9 %), somnolence (16.8 and 7 %, respectively) and peripheral edema (8.9 and 0.4 %, respectively). Despite the fact that the incidence of side effects for pregabalin is higher than that for the placebo and in some cases led to discontinuation of the drug, authors of the study reported good tolerability of pregabalin. Conclusions. The results of high-quality studies support the effectiveness of pregabalin in the treatment of patients with peripheral and central neuropathic pain. The drug was well tolerated.

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Published

2022-01-26

How to Cite

Marusychenko, V., & Yevtushenko, I. (2022). The Use of Pregabalin for the Treatment of Peripheral and Central Neuropathic Pain in Adults (Scientific Review). INTERNATIONAL NEUROLOGICAL JOURNAL, (2.80), 101–111. https://doi.org/10.22141/2224-0713.2.80.2016.74016

Issue

Section

Review