Effects of Pregabalin in Patients with Neuropathic Pain Previously Treated with Gabapentin: A Pooled Analysis of Parallel-Group, Randomized, Placebo-controlled Clinical Trials

Pain Pract. 2017 Jul;17(6):718-728. doi: 10.1111/papr.12516. Epub 2016 Dec 1.


Objectives: This analysis compared the therapeutic response of pregabalin in patients with neuropathic pain (NeP) who had been previously treated with gabapentin to the therapeutic response in patients who had not received gabapentin previously.

Methods: Data were pooled from 18 randomized, double-blind, placebo-controlled trials of pregabalin in patients with NeP. Pregabalin-mediated changes in pain and pain-related sleep interference scores, patient global impression of change scores at endpoint, and the occurrence of adverse events were compared between patients who had received gabapentin previously (+GBN) and patients who had not received gabapentin previously (-GBN).

Results: There were no significant differences between the -GBN and +GBN cohorts with regard to the extent of pain relief and relief of pain-related sleep interference for any dose of pregabalin (150, 300, 600, or 150 to 600 mg/day) at any time point (6, 8, or 12 weeks). Additionally, there was no significant difference in the distribution of patient global impression of change scores at study endpoint, or the occurrence of adverse events, between the -GBN and +GBN cohorts.

Discussion: The findings presented here support the idea that pregabalin may be used successfully to treat patients with NeP who may be refractory, respond inadequately, or are intolerant to gabapentin. These findings highlight the importance of tailoring treatment of NeP based on individual patient response to different treatments, including the trial of multiple agents within the same mechanistic class.

Trial registration: ClinicalTrials.gov NCT00159666 NCT00156078 NCT00159679 NCT00143156 NCT00301223 NCT00407745 NCT00553475.

Keywords: gabapentin; neuropathic pain; pregabalin; refractory.

Publication types

  • Meta-Analysis

MeSH terms

  • Adult
  • Amines / therapeutic use*
  • Analgesics / therapeutic use*
  • Cyclohexanecarboxylic Acids / therapeutic use*
  • Double-Blind Method
  • Female
  • Gabapentin
  • Humans
  • Male
  • Middle Aged
  • Neuralgia / diagnosis
  • Neuralgia / drug therapy*
  • Neuralgia / epidemiology
  • Pregabalin / therapeutic use*
  • Randomized Controlled Trials as Topic / methods*
  • Sleep / drug effects
  • Treatment Outcome
  • gamma-Aminobutyric Acid / therapeutic use*


  • Amines
  • Analgesics
  • Cyclohexanecarboxylic Acids
  • Pregabalin
  • gamma-Aminobutyric Acid
  • Gabapentin

Associated data

  • ClinicalTrials.gov/NCT00159666
  • ClinicalTrials.gov/NCT00156078
  • ClinicalTrials.gov/NCT00159679
  • ClinicalTrials.gov/NCT00143156
  • ClinicalTrials.gov/NCT00301223
  • ClinicalTrials.gov/NCT00407745
  • ClinicalTrials.gov/NCT00553475