Pregabalin, when used as an add‐on therapy for treatment‐resistant focal epilepsy, is significantly more effective than placebo at producing seizure reduction and seizure freedom, a new Cochrane review concludes.
Results demonstrated efficacy for doses from 150 mg/day to 600 mg/day. However, issues with tolerability were noted at higher doses.
The review included nine industry‐sponsored randomised controlled trials (3,327 participants), seven comparing pregabalin to placebo.
The data showed that participants randomised to pregabalin were significantly more likely to attain a 50 per cent or greater reduction in seizure frequency compared to placebo (risk ratio [RR] 2.28; 95% CI 1.52-3.42; 7 trials; 2,193 participants; low‐certainty evidence).
The odds of response doubled with an increase in dose from 300 mg/day to 600 mg/day (odds ratio [OR] 1.99; 95% CI 1.74-2.28), indicating a dose‐response relationship.
Pregabalin was significantly associated with seizure freedom (RR 3.94; 95% CI 1.50-10.37; 4 trials; 1,125 participants; moderate‐certainty evidence).
Participants were significantly more likely to withdraw from pregabalin treatment than placebo for any reason (RR 1.35; 95% CI 1.11-1.65; 7 trials; 2,193 participants; moderate‐certainty evidence) and for adverse effects (RR 2.65; 95% CI 1.88-3.74; 7 trials; 2,193 participants; moderate‐certainty evidence).