EFFICACY OF GABAPENTIN VERSUS PREGABALIN IN PATIENTS OF PAINFUL DIABETIC PERIPHERAL NEUROPATHY

Abstract

Introduction: Diabetic neuropathy is a common microvascular complication of diabetes mellitus. Major goal of pharmacological treatment in diabetic neuropathy is therefore to control pain. Several agents are used for relief of DPN, but Gabapentin and Pregabalin among the most widely prescribed pharmaceutical agents. The objective of study was to compare the efficacy of gabapentin versus pregabalin on symptomatic relief in patients with DPN. Material and Methods: This Randomized Control Trial was conducted at the Medicine OPD of Fauji Foundation Hospital, Islamabad. 150 patients of either sex with T2DM for more than 2 years having age between 25 and 75 years were enrolled. All patients were on any stable glucose-lowering medications for at least 4 weeks and having peripheral diabetic neuropathy. All the patients were randomly divided into two groups (75 patients in each group). Group A continued to be treated with Gabapentin at a dose of 600 mg/day and it was escalated to a maximum of 1800 mg/day once daily in night. Group B patients were given Pregabalin at a dose of 75 mg/day and it was escalated to a maximum of 300 mg/day once daily in night. Efficacy was assessed at 8th weeks. Data was analyzed on SPSS version 25.0. Chi square test was used to compare the efficacy of gabapentin and pregabalin in two groups after 8 weeks.
Students t-test was used to compare mean VAS post treatment in both groups and P value ≤0.05 considered significant.

Results: Pregabalin proved to be more effective than Gabapentin for treating DPN because patients in the Pregabalin group scored lower on VAS (3.79 ± 1.30) compared to the Gabapentin group (4.65 ± 1.27) (p < 0.001). The mean difference in VAS scores between the two groups was 0.87 (95% CI: 0.45 to 1.28), indicating a statistically significant reduction in pain with Pregabalin. On the other hand, a higher proportion of patients in the Pregabalin group (48.0%) achieved a ≥50% reduction in pain scores compared to the Gabapentin group (25.3%) (p < 0.001). This suggests that Pregabalin was more effective in achieving significant pain relief.
Conclusions: Pregabalin demonstrated superior efficacy compared to Gabapentin in reducing pain scores and achieving a ≥50% reduction in pain in patients with painful diabetic peripheral neuropathy. The efficacy of Pregabalin was consistently higher across various subgroups, including gender, age, BMI, duration of DPN, and HbA1C levels. These findings suggest that Pregabalin may be a more effective treatment option for managing painful DPN, particularly in specific patient subgroups.