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SYSTEMATIC REVIEW article

Front. Pain Res.
Sec. Pharmacological Treatment of Pain
Volume 5 - 2024 | doi: 10.3389/fpain.2024.1513597

Pregabalin versus Gabapentin in the Treatment of Neuropathic Pain: A Comprehensive Systematic Review and Meta-Analysis of Effectiveness and Safety

Provisionally accepted
Victor Mayoral Victor Mayoral 1*Rafael Galvez Rafael Galvez 2Maria Ferrandiz Maria Ferrandiz 3Xoán Miguéns Vázquez Xoán Miguéns Vázquez 4Carlos Cordero García Carlos Cordero García 5Antonio Alcántara Montero Antonio Alcántara Montero 6Concepción Pérez Concepción Pérez 7Maria Perez Maria Perez 8
  • 1 Bellvitge University Hospital, Barcelona, Spain
  • 2 Hospital University Complex of Granada, Granada, Spain
  • 3 Santa Creu i Sant Pau Hospital, Barcelona, Spain
  • 4 Complejo Hospitalario de Ourense, Ourense, Spain
  • 5 Hospital Juan Ramón Jiménez, Huelva, Spain
  • 6 Centro de Salud Trujillo, Cáceres, Spain
  • 7 Hospital de la Princesa, Madrid, Spain
  • 8 Viatris, Madrid, Spain

The final, formatted version of the article will be published soon.

    Introduction: Neuropathic 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 versus gabapentin in managing neuropathic pain. Methods: This 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. Results: A 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 to 0.68) and experienced more days with no/mild pain (MD 9.00, 95% CI 8.93 to 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 to 0.76). Gabapentin had a higher incidence of nausea and vomiting. Sensitivity analysis supported the efficacy of pregabalin. Conclusion: In 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.

    Keywords: pregabalin, gabapentin, neuropathic pain, Pain, Meta-analysis, Systematic review

    Received: 18 Oct 2024; Accepted: 20 Dec 2024.

    Copyright: © 2024 Mayoral, Galvez, Ferrandiz, Miguéns Vázquez, Cordero García, Montero, Pérez and Perez. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Victor Mayoral, Bellvitge University Hospital, Barcelona, Spain

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.