A phase 4 randomized active-controlled clinical study to compare the efficacy and safety of sustained-release pregabalin with immediate-release pregabalin in type 2 diabetic patients with peripheral neuropathic pain

J Diabetes Complications. 2024 Aug;38(8):108809. doi: 10.1016/j.jdiacomp.2024.108809. Epub 2024 Jul 14.

Abstract

Aims: The objective of this study was to demonstrate that sustained-release (SR) pregabalin is non-inferior to immediate-release (IR) pregabalin in attenuating diabetic peripheral neuropathic (DPN) pain along with patient satisfaction and compliance.

Methods: This was an 8-week, randomized, active-controlled, open-label, phase 4 study. Eligible subjects who had been on IR pregabalin for 4 weeks were randomized to 1:1 ratio to either continue with twice-daily IR pregabalin (75 mg), or to switch to once-daily SR pregabalin (150 mg). Primary efficacy endpoint was the change in visual analogue scale (VAS) scores after 8 weeks of treatment compared to baseline in both SR and IR pregabalin groups.

Results: Among 130 randomized subjects, 125 patients were included in full analysis set. For the change in VAS pain score, the least squares (LS) mean were -17.95 (SR pregabalin) and -18.74 (IR pregabalin) and the LS mean difference between both groups was 0.79, with the upper limit of the 95 % confidence interval [-5.99, 7.58] below the pre-specified non-inferiority margin of 9.2 mm.

Conclusions: This study demonstrates that the new once-daily SR pregabalin formulation is not different to the twice-daily IR pregabalin in alleviating DPN pain, indicating its potential as a promising treatment for DPN pain with a comparable safety profile.

Trial registration: ClinicalTrials.gov, NCT05624853.

Keywords: Diabetic peripheral neuropathy; Gastroretentive drug delivery system; Neuropathic pain; Pregabalin; Sustained-release.

Publication types

  • Randomized Controlled Trial
  • Clinical Trial, Phase IV
  • Comparative Study
  • Multicenter Study

MeSH terms

  • Adult
  • Aged
  • Analgesics* / administration & dosage
  • Analgesics* / adverse effects
  • Analgesics* / therapeutic use
  • Delayed-Action Preparations*
  • Diabetes Mellitus, Type 2* / complications
  • Diabetes Mellitus, Type 2* / drug therapy
  • Diabetic Neuropathies* / drug therapy
  • Drug Administration Schedule
  • Female
  • Humans
  • Male
  • Middle Aged
  • Neuralgia* / drug therapy
  • Pain Measurement
  • Patient Satisfaction
  • Pregabalin* / administration & dosage
  • Pregabalin* / adverse effects
  • Pregabalin* / therapeutic use
  • Treatment Outcome

Substances

  • Pregabalin
  • Delayed-Action Preparations
  • Analgesics

Associated data

  • ClinicalTrials.gov/NCT05624853