ArticleEfficacy of pregabalin in neuropathic pain evaluated in a 12-week, randomised, double-blind, multicentre, placebo-controlled trial of flexible- and fixed-dose regimensFreynhagen, Rainera,*; Strojek, Krzysztofb; Griesing, Teresac; Whalen, Edc; Balkenohl, Michaeld Author Information aKlinik für Anaesthesiologie, Universitätsklinikum Düsseldorf, Moorenstr. 5, 40225 Düsseldorf, Germany bDepartment of Internal Diseases, Diabetology and Nephrology, Zabrze, Poland cPfizer, Inc., New York, USA dPfizer Global Pharmaceuticals, Freiburg, Germany *Corresponding author. Tel.: +49 211 811 6157; fax: +49 211 811 9157. E-mail: [email protected] Submitted October 17, 2004; revised February 15, 2005; accepted February 28, 2005. Pain: June 2005 - Volume 115 - Issue 3 - p 254-263 doi: 10.1016/j.pain.2005.02.032 Buy Metrics Abstract Pregabalin binds with high affinity to the alpha2-delta subunit protein of voltage-gated calcium channels and, thereby, reduces release of excitatory neurotransmitters. This 12-week randomised, double-blind, multicentre, placebo-controlled, parallel-group study evaluated the efficacy and safety of pregabalin in patients with chronic postherpetic neuralgia (PHN) or painful diabetic peripheral neuropathy (DPN). Patients were randomised to placebo (n=65) or to one of two pregabalin regimens: a flexible schedule of 150, 300, 450, and 600 mg/day with weekly dose escalation based on patients' individual responses and tolerability (n=141) or a fixed schedule of 300 mg/day for 1 week followed by 600 mg/day for 11 weeks (n=132). Both flexible- and fixed-dose pregabalin significantly reduced endpoint mean pain score (primary outcome) versus placebo (P=0.002, P<0.001) and were significantly superior to placebo in improving pain-related sleep interference (P<0.001). The most common adverse events (AEs) for pregabalin-treated patients were dizziness, peripheral oedema, weight gain (not affecting diabetes control), and somnolence. These results are consistent with previous studies' demonstrating pregabalin's efficacy, tolerability, and safety for treatment of chronic neuropathic pain associated with DPN or PHN. Pregabalin dosing aimed at optimal balance of efficacy and tolerability provides significant pain relief and may reduce risks for AEs and therapy discontinuation. © 2005 Lippincott Williams & Wilkins, Inc.