Lyrica Fails in Sciatica Pain Save

Lyrica (pregabalin) was first approved in 2004 and since has been studied and approved for use in neuropathic pain (associated with diabetic neuropathy), postherpetic neuralgia, partial onset seizures, fibromyalgia and neuropathic pain with spinal cord injury. It is often used to manage chronic pain and neuropathic pain outside these indications.

Australian investigators published their findings in the NEJM last week showing that pregabalin was no better than placebo in treating leg pain associated with sciatics (acute or chronic). 

Patients (n=209) were randomized to either pregabalin at a dose of 150 mg per day (max adjusted to 600 mg per day) or placebo for 8 weeks. The primary outcome was the leg-pain using a 10-point scale at weeks 8 and 52. They also examined disability, back-pain intensity, and quality-of-life measures. Secondary measures demonstrated the same lack of effect.

There were 227 adverse events in the pregabalin group and 124 in the placebo group. Dizziness was more common in the pregabalin group than in the placebo group.

Pregabalin did not sufficiently reduce the leg pain of sciatica, short term or long term and was associated with a higher adverse event rate.