Efficacy and Safety of Pregabalin and Gabapentin for Pruritus: A Systematic Review and Meta-Analysis.

CONTEXT: Limited data existed on the efficacy and safety of novel antiepileptic drugs (pregabalin and gabapentin) in treating pruritus.

OBJECTIVES

To assess their role in managing either acute or chronic pruritus.

METHODS

A systematic search was conducted in PubMed, EMBASE, the Cochrane Library, and Web of Science databases for relevant randomized controlled trials. Pooled odd ratio (OR) with 95% CI were performed using RevMan5.4 and R4.3.1.

RESULTS

Analysis of 27 articles involving 2,016 patients showed significant reduction in pruritus incidence (OR, 0.30 [CI, 0.22-0.4]; I2=1%) and improvements in VAS (MD, 2.76 [CI, 0.95-4.57]; I2=98%) and 5-D scores (MD, 3.42 [CI, 2.10-4.75]; I2=92%) with pregabalin/gabapentin compared to controls. Adverse effects mainly included dizziness, somnolence, nausea and vomiting, dry mouth, constipation, and anxiety, with no significant difference between the groups (OR, 1.08 [CI, 0.32-3.59]; I2=76%).

CONCLUSION

The novel antiepileptic drugs pregabalin and gabapentin demonstrated significant therapeutic value in the treatment of pruritus, with a favorable safety profile. Compared to commonly used pruritus treatments such as antihistamines and antidepressants, these medications offered a promising alternative.