A systematic review and meta-analysis of the effectiveness and adverse events of gabapentin and pregabalin for sciatica pain.

Abstract

AIM:

This SR aims to assess the effectiveness of pregabalin and gabapentin on pain and disability caused by acute sciatica and the adverse events associated with their clinical use.

DESIGN:

Systematic review.

DATABASES:

Electronic databases of Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, and Clinical Trials.gov were searched from their inception until March 1st of 2021.

SELECTION CRITERIA:

Randomized trials (RCT) with adults>18 years old with acute sciatica for a minimum of 1 week and a maximum of 1 year (at least moderate pain).

DATA TREATMENT:

The outcomes were pain, disability and adverse events. Data was summarized using odds ratio and mean difference. GRADE was used to calculate the level of evidence.

RESULTS:

Eight RCT involving 747 participants were included. The effect of pregabalin was assessed in 3 RCT and in one three-arm trial (pregabalin vs limaprost vs a combination of limaprost and pregabalin). Two trials assessed the effect of gabapentin compared with placebo and one compared with tramadol. One study assessed the effect of gabapentin vs pregabalin in a crossover head-to-head trial. A statistically significant improvement on leg pain at 2 weeks and leg pain with movement at 3 and 4 months was found in a RCT comparing gabapentin with placebo. There were no statistically differences on the remaining time periods assessed for leg pain, low back pain and functional disability.

CONCLUSIONS:

This SR provides clear evidence for lack of effectiveness of pregabalin and gabapentin for sciatica pain management. In view of this, its routine clinical use cannot be supported.

• Authors: María Soledad Giménez-Campos, Pedro Pimenta-Fermisson-Ramos, Jose Israel Díaz-Cambronero, Rafael Carbonell-Sanchís, Eduardo López-Briz, Vicente Ruíz-García
• Journal: Atencion primaria (Aten Primaria) Vol. 54 Issue 1 Pg. 102144 (01 2022) ISSN: 1578-1275 [Electronic] Spain
• PMID: 34637958 (Publication Type: Journal Article, Meta-Analysis, Systematic Review)
• Copyright: Copyright © 2021 The Author(s). Publicado por Elsevier España, S.L.U. All rights reserved.

Chemical References

• Analgesics
• Pregabalin
• Gabapentin

Topics

• Adolescent
• Adult
• Analgesics (adverse effects)
• Gabapentin (adverse effects)
• Humans
• Low Back Pain
• Pregabalin (adverse effects)
• Sciatica (complications, drug therapy)