Introduction: This study was performed toexplore the efficacy and safety of pregabalin andgabapentin in patients with spinal cord injury(SCI)-induced neuropathic pain to determinewhich treatment is most suitable for suchpatients.
Methods: We searched the PubMed, MEDLINE,Embase, and Cochrane Library databases fromdatabase inception to August 31, 2020. Thequality of the included studies was assessed. Weselected the average pain intensity after treat-ment and the proportion of patients who dis-continued treatment because of adverse effectsas the outcome indicators for efficacy andsafety, respectively. Statistical analyses wereperformed using Stata, v16.0, and RevMan,v5.3, software.
Results: We included eight randomized con-trolled trials that examined four interventions(pregabalin, gabapentin, carbamazepine, andamitriptyline). Based on the average painintensity after treatment, the efficacy orderfrom highest to lowest was pregabalin, gaba-pentin, amitriptyline, carbamazepine, and pla-cebo. Based on the proportion of patients whodiscontinued treatment because of adverseeffects, the order from highest to lowest waspregabalin, amitriptyline, carbamazepine,gabapentin, and placebo. In addition, fivestudies reported the overall incidence of treat-ment-related adverse effects for two interven-tions (pregabalin and gabapentin). According tothe pooled analysis of these studies, the orderfor the overall incidence of treatment-relatedadverse effects from highest to lowest was pre-gabalin, gabapentin, and placebo.
Conclusions: This study revealed that forpatients with SCI-related neuropathic pain,pregabalin was the most effective for relievingpain, whereas gabapentin performed better inaspects associated with drug therapy-related safety.