For adults with postherpetic neuralgia, how does pregabalin compare with placebo?

Abstract

More adults with postherpetic neuralgia have pain relief with pregabalin 150 to 600 mg daily than with placebo, but harms are more common with doses of 300 to 600 mg.More adults with moderate or severe postherpetic neuralgia persisting for at least three months after rash healing had their pain intensity reduced by at least 30% with daily pregabalin for 4 to 13 weeks (from 219 to 383 more people per 1000 with doses of 150 mg to 600 mg, respectively; all results on average) compared with people given placebo (moderate‐certainty evidence). Researchers found similar reduction in pain intensity by at least 50% with pregabalin 150 mg to 600 mg (from 147 to 255 more people per 1000) (low‐ to moderate‐certainty evidence). Also, more people showed much or very much improvement on the Patient Global Impression of Change (PGIC) with pregabalin 150 to 600 mg (from 128 to 206 more people per 1000 than with placebo) (low‐ to very low‐certainty evidence).High‐certainty evidence shows that fewer people withdrew because of lack of efficacy with pregabalin (from 25 to 44 fewer per 1000 people than with placebo across doses of 150 mg to 600 mg), but more people withdrew because of adverse events with pregabalin 300 mg to 600 mg (from 92 to 138 more people than with placebo); withdrawal rates were similar for 150 mg.More people experienced adverse events with pregabalin (from 713 to 843 per 1000 people) than with placebo (from 502 to 633 per 1000 people), although this result did not reach statistical significance with the 150‐mg dose. The rate of serious adverse events was low for any pregabalin dose, and no clear increase was seen with any dose.More people experienced somnolence and dizziness with pregabalin (moderate‐certainty evidence) than with placebo.