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. 2021 Dec;10(2):1497-1509.
doi: 10.1007/s40122-021-00302-8. Epub 2021 Sep 7.

Pregabalin and Gabapentin in Patients with Spinal Cord Injury-Related Neuropathic Pain: A Network Meta-Analysis

Chen Tong #  1 , Zuo Zhengyao #  2 , Li Mei  2 , Su Dongpo  2 , Han Qian  2 , Mu Fengqun  3
Affiliations

Pregabalin and Gabapentin in Patients with Spinal Cord Injury-Related Neuropathic Pain: A Network Meta-Analysis

Chen Tong et al. Pain Ther. 2021 Dec.

Abstract

Introduction: This study was performed to explore the efficacy and safety of pregabalin and gabapentin in patients with spinal cord injury (SCI)-induced neuropathic pain to determine which treatment is most suitable for such patients.

Methods: We searched the PubMed, MEDLINE, Embase, and Cochrane Library databases from database inception to August 31, 2020. The quality of the included studies was assessed. We selected the average pain intensity after treatment and the proportion of patients who discontinued treatment because of adverse effects as the outcome indicators for efficacy and safety, respectively. Statistical analyses were performed using Stata, v16.0, and RevMan, v5.3, software.

Results: We included eight randomized controlled trials that examined four interventions (pregabalin, gabapentin, carbamazepine, and amitriptyline). Based on the average pain intensity after treatment, the efficacy order from highest to lowest was pregabalin, gabapentin, amitriptyline, carbamazepine, and placebo. Based on the proportion of patients who discontinued treatment because of adverse effects, the order from highest to lowest was pregabalin, amitriptyline, carbamazepine, gabapentin, and placebo. In addition, five studies reported the overall incidence of treatment-related adverse effects for two interventions (pregabalin and gabapentin). According to the pooled analysis of these studies, the order for the overall incidence of treatment-related adverse effects from highest to lowest was pregabalin, gabapentin, and placebo.

Conclusions: This study revealed that for patients with SCI-related neuropathic pain, pregabalin was the most effective for relieving pain, whereas gabapentin performed better in aspects associated with drug therapy-related safety.

Keywords: Gabapentin; Network meta-analysis; Neuropathic pain; Pregabalin; Spinal cord injury.

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Figures

Fig. 1
Fig. 1
Flow chart of the study selection process
Fig. 2
Fig. 2
Quality assessment of the identified randomized controlled trials
Fig. 3
Fig. 3
a Network chart based on the average pain intensity after treatment. b Network chart based on the proportion of patients who discontinued treatment because of adverse treatment effects. *PGB pregabalin, GBP gabapentin
Fig. 4
Fig. 4
a Treatment rankings based on the average pain intensity after treatment. b Treatment rankings based on the proportion of patients who discontinued treatment because of adverse treatment effects. *PGB pregabalin, GBP gabapentin
See this image and copyright information in PMC

References

    1. Cardenas DD, Felix ER. Pain after spinal cord injury: a review of classification, treatment approaches, and treatment assessment. PM R. 2009;1:1077–1090. doi: 10.1016/j.pmrj.2009.07.002. - DOI - PubMed
    1. Felix ER. Chronic neuropathic pain in SCI: evaluation and treatment. Phys Med Rehabil Clin N Am. 2014;25:545–571. doi: 10.1016/j.pmr.2014.04.007. - DOI - PubMed
    1. D’Angelo R, Morreale A, Donadio V, Boriani S, Liguori R. Neuropathic pain following spinal cord injury: what we know about mechanisms, assessment and management. Eur Rev Med Pharmacol Sci. 2013;17:3257–3261. - PubMed
    1. Budh CN, Osteraker AL. Life satisfaction in individuals with a spinal cord injury and pain. Clin Rehabil. 2007;21:89–96. doi: 10.1177/0269215506070313. - DOI - PubMed
    1. Donnelly C, Eng JJ. Pain following spinal cord injury: the impact on community reintegration. Spinal Cord. 2005;43:278–282. doi: 10.1038/sj.sc.3101702. - DOI - PMC - PubMed

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