Efficacy and Safety of Pregabalin and Gabapentin for Pruritus: A Systematic Review and Meta-Analysis
Wenting Xu, Hanyue Dong, Hao-Long Ran, Huan Liu, Lin Wang, Hongmin Li, Cheng Tan
Abstract
<h2>Abstract</h2><h3>Context</h3> Limited data existed on the efficacy and safety of novel antiepileptic drugs (pregabalin and gabapentin) in treating pruritus. <h3>Objectives</h3> To assess their role in managing either acute or chronic pruritus. <h3>Methods</h3> A systematic search was conducted in PubMed, EMBASE, the Cochrane Library, and Web of Science databases for relevant randomized controlled trials. Pooled odd ratio (OR) with 95% CI were performed using RevMan5.4 and R4.3.1. <h3>Results</h3> Analysis of 27 articles involving 2,016 patients showed significant reduction in pruritus incidence (OR, 0.30 [CI, 0.22–0.4]; I<sup>2</sup>=1%) and improvements in VAS (MD, 2.76 [CI, 0.95–4.57]; I<sup>2</sup>=98%) and 5-D scores (MD, 3.42 [CI, 2.10–4.75]; I<sup>2</sup>=92%) with pregabalin/gabapentin compared to controls. Adverse effects mainly included dizziness, somnolence, nausea and vomiting, dry mouth, constipation, and anxiety, with no significant difference between the groups (OR, 1.08 [CI, 0.32–3.59]; I<sup>2</sup>=76%). <h3>Conclusion</h3> The novel antiepileptic drugs pregabalin and gabapentin demonstrated significant therapeutic value in the treatment of pruritus, with a favorable safety profile. Compared to commonly used pruritus treatments such as antihistamines and antidepressants, these medications offered a promising alternative.