Meta-analysis of pregabalin combined with different methods for treating postherpetic neuralgia.

Abstract

Objective: To conduct a meta-analysis of the literature on the treatment of postherpetic neuralgia (PHN) with pregabalin combined with different methods.

Methods: Search for relevant literature on the treatment of postherpetic neuralgia with pregabalin combined with different methods in both Chinese and English databases, including PubMed, Web of science, Cochrane Library, Wanfang Data, and China National Knowledge Infrastructure (CNKI).

Results: The final inclusion consisted of 29 articles published between 2009 and 2023, with a total of 2,738 patients. Among them, 22 articles were RCTs, and 7 were non-RCTs. Seven articles reported on NRS, and the meta-analysis of continuous variable showed that the NRS scores in the study group were significantly lower than in the control group (OR = -1.05, 95% CI: -1.37 to -0.73, Z = -6.47, P < 0.01). Seven articles reported on breakthrough pain, and the meta-analysis of continuous variable showed that the frequency of breakthrough pain in the study group was significantly lower than in the control group (OR = -1.23, 95% CI: -1.52 to -0.94, Z = -8.31, P < 0.01). Five articles reported on SF-MPQ, and the meta-analysis of continuous variable showed that the SF-MPQ in the study group was significantly lower than in the control group (OR = -1.47, 95% CI: -2.14 to -0.81, Z = -4.33, P < 0.01). Ten articles reported on sleep quality, and the meta-analysis of continuous variable showed that the sleep quality scores in the study group were significantly lower than in the control group (OR = -2.16, 95% CI: -3.46 to -0.86, Z = -3.26, P < 0.01). Twenty articles reported on VAS, and the meta-analysis of continuous variable showed that the VAS scores in the study group were significantly lower than in the control group (OR = -1.17, 95% CI: -1.49 to -0.85, Z = -7.15, P < 0.01). Seven articles reported on efficacy, and the meta-analysis of dichotomous variable showed that the efficacy in the study group was significantly higher than in the control group (OR = 1.45, 95% CI: 0.94 to 1.95, Z = 5.65, P < 0.01). Thirteen articles reported on adverse reactions, and the meta-analysis of dichotomous variable showed no statistically significant difference in adverse reactions between the study and control groups (OR = 0.31, 95% CI: -0.01 to 0.62, Z = 1.92, P = 0.06). Ten articles reported on quality of life, and the meta-analysis of continuous variable showed that the quality of life scores in the study group were significantly higher than in the control group (OR = 1.00, 95% CI: 0.73 to 1.27, Z = 7.20, P < 0.01). Eleven articles reported on pregabalin dosage, and the meta-analysis of continuous variable showed that the dosage of pregabalin in the study group was significantly lower than in the control group (OR = -2.55, 95% CI: -3.15 to -1.95, Z = -8.30, P < 0.01). Funnel plot analysis indicated publication bias in VAS and pregabalin dosage but no publication bias in adverse reactions.

Conclusion: Pregabalin combined with electroacupuncture, medications, pulsed radiofrequency, and nerve stimulation has shown good efficacy in the treatment of PHN and can be flexibly applied based on clinical practice.