Gabapentin versus Pregabalin for management of chronic inflammatory demyelinating polyradiculoneuropathy.

INTRODUCTION: Chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) is a chronic autoimmune demyelinating peripheral neuropathy that leads to symmetrical muscular weakness, sensory deficit, hyporeflexia, chronic fatigue, and impaired quality of life (QoL). The current study aims to investigate the effects of gabapentin versus pregabalin on pain, sleep disturbances, and QoL in CIDP patients.

METHODS: This clinical trial was conducted on 40 patients diagnosed with CIDP randomly allocated to treatment with 100-500 mg gabapentin (n=20) or 50-300 mg pregabalin (n=20) both co-medicated with 37.5 mg venlafaxine. The dose of gabapentin/pregabalin was adjusted based on the patient's tolerability/response to the treatment. Visual analogue scale (VAS), Pittsburg Sleep Quality Questionnaire and Short Form Health Survey (SF-36) were filled at baseline, within three, six, nine and 12 months after the interventions to assess pain severity, sleep quality and QoL, respectively. The Iranian Registry of Clinical Trials (IRCT) code: IRCT20200217046523N16, https://fa.irct.ir/search/result?query=IRCT20200217046523N16.

RESULTS: Gabapentin revealed a dose-dependent efficacy in pain severity ( P -value =0.004, r=0.287), sleep quality ( P -value <0.001, r=0.387) and QoL ( P -value =0.001, r=-0.378), but pregabalin ( P -value >0.05). Co-medication of gabapentin plus venlafaxine could significantly improve sleep quality ( P -value =0.009) and QoL ( P -value =0.004), but pain severity ( P -value =0.796). Pregabalin plus venlafaxine showed statistically significant improvement in pain ( P -value =0.046), sleep quality ( P -value <0.001) and QoL ( P -value <0.001). The comparison of the two medications revealed the superiority of pregabalin in pain relief ( P -value >0.001) and QoL ( P -value =0.03) to pregabalin.

CONCLUSION: Based on this study, the co-medication of pregabalin and venlafaxine led to remarkable superior outcomes compared to venlafaxine plus gabapentin in the management of pain, sleep quality, and QoL due to CIDP.