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Efficacy and Safety of Pregabalin in Neuropathic Pain Followed Spinal Cord Injury

A Review and Meta-Analysis of Randomized Controlled Trials

Yu, Xiaobing, MD*,†,‡; Liu, Tao, MD*; Zhao, Dewei, MD*,†; Yang, Ke, MD; Zhang, Xiuzhi, MD*; Zhang, Meng, MD*; Zhang, Shuo, MD*; Huang, Wei, MD*; Wu, Baolin, MD*; Li, Junlei, MD*

doi: 10.1097/AJP.0000000000000675
Review Articles

Objective: Pregabalin has been approved for the treatment of the neuropathic pain following spinal cord injury (SCI). We performed a systemic review and meta-analysis of randomized, controlled, multicenter trials to evaluate the efficacy and safety of pregabalin for SCI-induced neuropathic pain.

Materials and Methods: Research searching was performed in PubMed and EMBASE databases and the Cochrane library in May 2018. Clinical controlled trials using pregabalin for the pain treatment following SCI in adults (18 y old and above) were included. Pain and safety-related adverse events were considered as outcomes. Meta-analysis was conducted using Revman 5.0 software.

Results: Five publications (pregabalin, patients=261, placebo, patients=216) were included in our study. After at least 4-week’s treatment with pregabalin (flexible dose, 150 to 600 mg/d), pregabalin-treated patients showed reduced pain −1.54, 95% confidence interval (CI) (−2.33, −0.75), P=0.0001; improved >30% 1.83, 95% CI (1.37, 2.46), P<0.0001 and >50% pain relief 2.40, 95% CI (1.53, 3.77), P=0.0001; increased adverse events 1.36, 95% CI (1.18, 1.577), P<0.0001; and reduced Hospital Anxiety and Depression Scale - anxiety −1.50, 95% CI (−2.99, −0.00), P=0.05 and - depression −0.34, 95% CI (−0.55, −0.12), P=0.002 scores compared with placebo-treated patients. Stratified meta-analysis showed there was no difference in primary adverse events (drowsiness, dizziness, peripheral edema, and dry mouth) between pregabalin and placebo groups (P≥0.05).

Conclusions: Our results showed pregabalin was efficacious and might be safe treatment for chronic pain followed SCI.

*Department of Orthopaedics

Postdoctoral Workstation, Zhongshan Hospital of Dalian University, Dalian

Institute of Metal Research, Chinese Academy of Science, Shenyang, China

X.Y. and T.L. contributed equally.

X.Y., K.Y., and D.Z.: conceived and designed the study. B.W., X.Z., and M.Z.: performed the experiments. S.Z.: provided the mutants. T.L. and B.W.: wrote the paper. W.H., T.L., and J.L.: reviewed and edited the manuscript.

The authors declare no conflict of interest.

Reprints: Xiaobing Yu, MD, No. 6, Jiefang Street, Dalian, Liaoning province 116001, China (e-mail: dldxyxb@163.com).

Received August 21, 2018

Received in revised form October 19, 2018

Accepted November 11, 2018

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