Pregabalin add-on for drug-resistant focal epilepsy

Abstract

Study characteristics This review examined data from 9 trials including a total of 3327 participants. Study participants were assigned using a random method to take pregabalin, placebo, or another antiepileptic drug in addition to their usual antiepileptic drugs. Key results Participants taking pregabalin were more than twice as likely to have their seizure frequency reduced by 50% or more during a 12week treatment period compared to those taking placebo, and were nearly four times more likely to be completely free of seizures. Pregabalin was shown to be e ective across a range of doses (150 mg to 600 mg), with increasing e ectiveness at higher doses. There was also an increased likelihood of treatment withdrawal with pregabalin. Side e ects associated with pregabalin included ataxia, dizziness, fatigue, somnolence, and weight gain. When pregabalin was compared to three other antiepileptic drugs (lamotrigine, levetiracetam, and gabapentin), participants taking pregabalin were more likely to achieve a 50% reduction in seizure frequency than those taking lamotrigine. We found no significant di erences between pregabalin and levetiracetam or gabapentin as add-on drugs. Certainty of the evidence We rated all included studies as at low or unclear in risk of bias due to missing information about the methods used to conduct the trial and a suspicion of publication bias. Publication bias can occur when studies that report non-significant findings are not published. We suspected publication bias because the majority of included studies showed significant findings and were sponsored by the same drug company. We assessed the certainty of the evidence for the primary outcome of reduction in seizure frequency as low, meaning that we Pregabalin add-on for drug-resistant focal epilepsy (Review)

Pregabalin as adjunctive therapy in adult and pediatric patients with generalized tonic‐clonic seizures: A randomized, placebo‐controlled trial

“…The present study revealed no significant reduction in 28‐day GTC seizure frequency with adjunctive pregabalin treatment compared with placebo treatment. Although no significant reduction in GTC seizure frequency or responder status was seen, pregabalin did not increase GTC or myoclonic seizures and demonstrated a safety profile consistent with the known safety profile in patients with other epileptic syndromes, including in adults and children with FOS 17,18,26,33 . The most common AEs reported in adults with FOS include dizziness, somnolence, and weight gain, 17 consistent with the common AEs recorded in this GTC population.…”

“…Although no significant reduction in GTC seizure frequency or responder status was seen, pregabalin did not increase GTC or myoclonic seizures and demonstrated a safety profile consistent with the known safety profile in patients with other epileptic syndromes, including in adults and children with FOS. 17,18,26,33 The most common AEs reported in adults with FOS include dizziness, somnolence, and weight gain, 17 consistent with the common AEs recorded in this GTC population. We observed a gradual decline in GTC seizure frequency in all three treatment arms over the treatment period; however as patients were allowed to continue stable concomitant medications during the treatment phase, these may have influenced these observations.…”

Antiepileptic medicines in men and women with stroke in Sweden, a registry‐based study

“…The evidence for pregabalin use in central neuropathic pain, such as poststroke pain, is limited and a recent meta‐analysis described it as inadequate 18 . Pregabalin is not indicated as monotherapy in epilepsy as the evidence of effect is as an add‐on only 19,20 . As the present study analyses first dispensation of AED (ie, incident treatment), we interpret virtually all pregabalin to be on the indications neuropathic pain or generalized anxiety syndrome 20 .…”

Pharmacological treatment of focal epilepsy in adults: an evidence based approach

“…Despite meta-analyses do not seem to disfavour TGB, the association with cases of status epilepticus [38] made this drug less and less popular. There are three trials comparing pregabalin (PGB) to LTG, LEV and GBP, showing that PGB has higher response rates than LTG (RR 1.47; 95%CI 1.03-2.12) but not higher than LEV or GBP [39].…”