Gabapentin beats pregabalin for chronic sciatica

(HealthDay)—For patients with chronic sciatica (CS), gabapentin (GBP) is superior to pregabalin (PGB), with fewer and less severe adverse events (AEs), according to a study published online Oct. 15 in JAMA Neurology.

Kelvin Robertson, from The Townsville Hospital in Australia, and colleagues conducted a preplanned interim analysis of a randomized, double-dummy crossover trial of PGB and GBP for management of CS. Twenty patients were randomly assigned to GBP then PGB or vice versa, each taken for eight weeks, with a one-week washout before crossover; two patients were excluded.

The researchers found that GBP was superior to PGB, with fewer and less severe AEs recorded. Significant visual analogue pain intensity scale reduction (GBP: mean, 7.54 to 5.82; PGB: mean, 7.33 to 6.38) and Oswestry Disability Index reduction (mean, 59.22 to 48.54) was seen for both GBP and PGB. In head-to-head comparison, GBP showed superior reduction in the visual analogue pain intensity scale (mean, GBP: 1.72 versus PGB: 0.94), regardless of the sequence order; the Oswestry Disability Index reduction was unchanged. More frequent adverse events were seen for PGB (81 versus 19 percent), especially when it was taken first.

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