Pregabalin in the Management of Painful Diabetic Neuropathy

A Narrative Review

Shazli Azmi, Kariem T. ElHadd, Andrew Nelson, Adam Chapman, Frank L. Bowling, Anughara Perumbalath, Jonathan Lim, Andrew Marshall, Rayaz Malik, Uazman Alam

Research output: Contribution to journalReview article

Abstract

Pregabalin is a first-line treatment in all major international guidelines on the management of painful diabetic neuropathy (pDPN). Treatment with pregabalin leads to a clinically meaningful improvement in pain scores, offers consistent relief of pain and has an acceptable tolerance level. Despite its efficacy in relieving neuropathic pain, more robust methods and comprehensive studies are required to evaluate its effects in relation to co-morbid anxiety and sleep interference in pDPN. The sustained benefits of modulating pain have prompted further exploration of other potential target sites and the development of alternative GABAergic agents such as mirogabalin. This review evaluates the role of pregabalin in the management of pDPN as well as its potential adverse effects, such as somnolence and dizziness, which can lead to withdrawal in ~ 30% of long-term use. Recent concern about misuse and an increase in deaths linked to its use has led to demands for reclassification of pregabalin as a class C controlled substance in the UK. We believe these demands need to be tempered in relation to the difficulties it would create for repeat prescriptions for the many millions of patients with pDPN for whom pregabalin provides benefit. Plain Language Summary: Plain language summary available for this article.

Original languageEnglish
Pages (from-to)35-56
Number of pages22
JournalDiabetes Therapy
Volume10
Issue number1
DOIs
Publication statusPublished - 1 Feb 2019

Fingerprint

Diabetic Neuropathies
Pain
Language
Controlled Substances
GABA Agents
Dizziness
Neuralgia
Prescriptions
Sleep
Anxiety
Pregabalin
Guidelines
Therapeutics

Keywords

  • Anxiety
  • GABAergic therapy
  • Neuropathic pain
  • Painful diabetic neuropathy
  • Pregabalin
  • Sleep interference

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism

Cite this

Azmi, S., ElHadd, K. T., Nelson, A., Chapman, A., Bowling, F. L., Perumbalath, A., ... Alam, U. (2019). Pregabalin in the Management of Painful Diabetic Neuropathy: A Narrative Review. Diabetes Therapy, 10(1), 35-56. https://doi.org/10.1007/s13300-018-0550-x

Pregabalin in the Management of Painful Diabetic Neuropathy : A Narrative Review. / Azmi, Shazli; ElHadd, Kariem T.; Nelson, Andrew; Chapman, Adam; Bowling, Frank L.; Perumbalath, Anughara; Lim, Jonathan; Marshall, Andrew; Malik, Rayaz; Alam, Uazman.

In: Diabetes Therapy, Vol. 10, No. 1, 01.02.2019, p. 35-56.

Research output: Contribution to journalReview article

Azmi, S, ElHadd, KT, Nelson, A, Chapman, A, Bowling, FL, Perumbalath, A, Lim, J, Marshall, A, Malik, R & Alam, U 2019, 'Pregabalin in the Management of Painful Diabetic Neuropathy: A Narrative Review', Diabetes Therapy, vol. 10, no. 1, pp. 35-56. https://doi.org/10.1007/s13300-018-0550-x
Azmi S, ElHadd KT, Nelson A, Chapman A, Bowling FL, Perumbalath A et al. Pregabalin in the Management of Painful Diabetic Neuropathy: A Narrative Review. Diabetes Therapy. 2019 Feb 1;10(1):35-56. https://doi.org/10.1007/s13300-018-0550-x
Azmi, Shazli ; ElHadd, Kariem T. ; Nelson, Andrew ; Chapman, Adam ; Bowling, Frank L. ; Perumbalath, Anughara ; Lim, Jonathan ; Marshall, Andrew ; Malik, Rayaz ; Alam, Uazman. / Pregabalin in the Management of Painful Diabetic Neuropathy : A Narrative Review. In: Diabetes Therapy. 2019 ; Vol. 10, No. 1. pp. 35-56.
@article{23f250b906a54949966ac83a1e586371,
title = "Pregabalin in the Management of Painful Diabetic Neuropathy: A Narrative Review",
abstract = "Pregabalin is a first-line treatment in all major international guidelines on the management of painful diabetic neuropathy (pDPN). Treatment with pregabalin leads to a clinically meaningful improvement in pain scores, offers consistent relief of pain and has an acceptable tolerance level. Despite its efficacy in relieving neuropathic pain, more robust methods and comprehensive studies are required to evaluate its effects in relation to co-morbid anxiety and sleep interference in pDPN. The sustained benefits of modulating pain have prompted further exploration of other potential target sites and the development of alternative GABAergic agents such as mirogabalin. This review evaluates the role of pregabalin in the management of pDPN as well as its potential adverse effects, such as somnolence and dizziness, which can lead to withdrawal in ~ 30{\%} of long-term use. Recent concern about misuse and an increase in deaths linked to its use has led to demands for reclassification of pregabalin as a class C controlled substance in the UK. We believe these demands need to be tempered in relation to the difficulties it would create for repeat prescriptions for the many millions of patients with pDPN for whom pregabalin provides benefit. Plain Language Summary: Plain language summary available for this article.",
keywords = "Anxiety, GABAergic therapy, Neuropathic pain, Painful diabetic neuropathy, Pregabalin, Sleep interference",
author = "Shazli Azmi and ElHadd, {Kariem T.} and Andrew Nelson and Adam Chapman and Bowling, {Frank L.} and Anughara Perumbalath and Jonathan Lim and Andrew Marshall and Rayaz Malik and Uazman Alam",
year = "2019",
month = "2",
day = "1",
doi = "10.1007/s13300-018-0550-x",
language = "English",
volume = "10",
pages = "35--56",
journal = "Diabetes Therapy",
issn = "1869-6953",
publisher = "Springer Publishing Company",
number = "1",

}

TY - JOUR

T1 - Pregabalin in the Management of Painful Diabetic Neuropathy

T2 - A Narrative Review

AU - Azmi, Shazli

AU - ElHadd, Kariem T.

AU - Nelson, Andrew

AU - Chapman, Adam

AU - Bowling, Frank L.

AU - Perumbalath, Anughara

AU - Lim, Jonathan

AU - Marshall, Andrew

AU - Malik, Rayaz

AU - Alam, Uazman

PY - 2019/2/1

Y1 - 2019/2/1

N2 - Pregabalin is a first-line treatment in all major international guidelines on the management of painful diabetic neuropathy (pDPN). Treatment with pregabalin leads to a clinically meaningful improvement in pain scores, offers consistent relief of pain and has an acceptable tolerance level. Despite its efficacy in relieving neuropathic pain, more robust methods and comprehensive studies are required to evaluate its effects in relation to co-morbid anxiety and sleep interference in pDPN. The sustained benefits of modulating pain have prompted further exploration of other potential target sites and the development of alternative GABAergic agents such as mirogabalin. This review evaluates the role of pregabalin in the management of pDPN as well as its potential adverse effects, such as somnolence and dizziness, which can lead to withdrawal in ~ 30% of long-term use. Recent concern about misuse and an increase in deaths linked to its use has led to demands for reclassification of pregabalin as a class C controlled substance in the UK. We believe these demands need to be tempered in relation to the difficulties it would create for repeat prescriptions for the many millions of patients with pDPN for whom pregabalin provides benefit. Plain Language Summary: Plain language summary available for this article.

AB - Pregabalin is a first-line treatment in all major international guidelines on the management of painful diabetic neuropathy (pDPN). Treatment with pregabalin leads to a clinically meaningful improvement in pain scores, offers consistent relief of pain and has an acceptable tolerance level. Despite its efficacy in relieving neuropathic pain, more robust methods and comprehensive studies are required to evaluate its effects in relation to co-morbid anxiety and sleep interference in pDPN. The sustained benefits of modulating pain have prompted further exploration of other potential target sites and the development of alternative GABAergic agents such as mirogabalin. This review evaluates the role of pregabalin in the management of pDPN as well as its potential adverse effects, such as somnolence and dizziness, which can lead to withdrawal in ~ 30% of long-term use. Recent concern about misuse and an increase in deaths linked to its use has led to demands for reclassification of pregabalin as a class C controlled substance in the UK. We believe these demands need to be tempered in relation to the difficulties it would create for repeat prescriptions for the many millions of patients with pDPN for whom pregabalin provides benefit. Plain Language Summary: Plain language summary available for this article.

KW - Anxiety

KW - GABAergic therapy

KW - Neuropathic pain

KW - Painful diabetic neuropathy

KW - Pregabalin

KW - Sleep interference

UR - http://www.scopus.com/inward/record.url?scp=85060725717&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85060725717&partnerID=8YFLogxK

U2 - 10.1007/s13300-018-0550-x

DO - 10.1007/s13300-018-0550-x

M3 - Review article

VL - 10

SP - 35

EP - 56

JO - Diabetes Therapy

JF - Diabetes Therapy

SN - 1869-6953

IS - 1

ER -