Pregabalin administration in patients with fibromyalgia: a Bayesian network meta-analysis

Area of Science:

• Pharmacology and Therapeutics
• Clinical Medicine
• Evidence-Based Medicine

Background:

• Fibromyalgia treatment effectiveness and safety vary with pregabalin dosage.
• Optimal pregabalin dosage protocols for fibromyalgia remain undetermined.
• Existing research lacks a comprehensive comparison of different pregabalin doses.

Purpose of the Study:

• To conduct a Bayesian network meta-analysis comparing pregabalin doses (300, 450, 600 mg/daily) for fibromyalgia.
• To evaluate the efficacy and safety of different pregabalin dosages on key fibromyalgia outcomes.
• To provide evidence-based recommendations for personalized pregabalin treatment in fibromyalgia.

Main Methods:

• Systematic literature search for double-blind randomized clinical trials (RCTs) up to January 2022.
• Inclusion criteria: RCTs comparing at least two pregabalin doses, >50 patients, and >8 weeks follow-up.
• Bayesian hierarchical random-effects model meta-analysis using log odds ratio (LOR) and standardized mean difference (SMD).

Main Results:

• Pregabalin 450 mg/daily showed the greatest reduction in Fibromyalgia Impact Questionnaire (FIQ) scores (SMD -1.83).
• Pregabalin 600 mg/daily demonstrated the most significant improvement in sleep quality (SMD 0.15).
• Pregabalin 300 mg/daily was associated with the lowest rate of adverse events (LOR 0.12).

Conclusions:

• Pregabalin efficacy and safety profiles differ across dosages (300, 450, 600 mg/daily) in fibromyalgia.
• Optimal pregabalin dosage should be individualized based on patient characteristics and primary symptoms.
• This meta-analysis supports tailored therapeutic strategies for fibromyalgia management with pregabalin.