HOME

Review Article

The Korean Journal of Pain 2020; 33(1): 3-12

Published online January 1, 2020 https://doi.org/10.3344/kjp.2020.33.1.3

Copyright © The Korean Pain Society.

Pregabalin and gabapentin in neuropathic pain management after spinal cord injury: a systematic review and meta-analysis

Majid Davari1 , Bahman Amani2 , Behnam Amani2 , Ahmad Khanijahani3 , Arash Akbarzadeh4 , and Rouhollah Shabestan4

1Department of Pharmacoeconomics and Pharmaceutical Administration, Tehran University of Medical Sciences, Tehran, Iran
2Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
3Department of Health Administration and Public Health, John G. Rangos School of Health Sciences, Duquesne University, Pittsburgh, PA, USA
4Department of Biostatistics and Epidemiology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran

Correspondence to:Bahman Amani
Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Qods St., Keshavarz Blvd., Tehran 00982113, Iran
Tel: +98-933-308-2779
Fax: +98-21-663-57166
E-mail: B89amani@yahoo.com

Received: July 18, 2019; Revised: December 10, 2019; Accepted: December 10, 2019

This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Neuropathic pain after spinal cord injury (SCI) has a significant negative impact on the patients’ quality of life. The objective of this systematic review is to examine the safety and efficacy of pregabalin (PGB) and gabapentin (GBP) in the treatment of neuropathic pain due to SCI. PubMed, the Cochrane Library, Embase, Scopus, and the Web of Science were searched up to December 2018. The reference lists of key and review studies were reviewed for additional citations. The quality of the studies was evaluated using the Cochrane Collaboration’s tools for assessing the risk of bias. A meta-analysis was performed for primary and secondary outcomes. Eight studies were eligible for inclusion. Meta-analysis of PGB vs. placebo showed that PGB was effective for neuropathic pain (standardized mean difference [SMD] = −0.40; 95% confidence interval [CI]: −0.78, −0.01), anxiety (MD = −0.68; 95% CI: −0.77, −0.59), depression (mean difference [MD] = −0.99; 95% CI: −1.08, −0.89), and sleep interference (MD = −1.08; 95% CI: −1.13, −1.02). Also, GBP was more effective than a placebo for reducing pain. No significant difference was observed between the efficacy of the two drugs (MD = −0.37; 95% CI: −1.67, 0.93). There was no significant difference between the two drugs for discontinuation due to adverse events (risk ratio = 3.00; 95% CI: 0.81, 11.15). PGB and GBP were effective vs. placebos in decreasing neuropathic pain after SCI. Also, there was no significant difference between the two drugs for decreasing pain and adverse events.

Keywords: Anxiety, Depression, Gabapentin, Meta-Analysis, Neuralgia, Pain, Pregabalin, Spinal Cord Injuries, Systematic Review.