Comparative Effectiveness of Gabapentin and Pregabalin Combination Therapy in Postherpetic Neuralgia: A Single-Masked Randomised Controlled Trial

Abstract

Objective: To compare the efficacy of gabapentin combined with pregabalin in postherpetic neuralgia (PHN) attenuation, focusing on patient-reported outcomes and inflammatory cytokine reduction. Study Design: Single-blinded randomised controlled trial. Place and Duration of the Study: Department of Dermatology, Zhongnan Hospital of Wuhan University, Wuhan, China, from June to December 2022. Methodology: A total of 134 consecutive patients diagnosed with PHN were randomly allocated into two groups: gabapentin alone (GB group, n = 67) or a combination of gabapentin and pregabalin (GBP group, n = 67) administered orally for 8 weeks. The outcome measures, including the visual analogue scale (VAS) score, clinical efficacy rate, and serum inflammatory factors, were analysed using the t-test, paired t-test, or χ2 test. Results: At 8 weeks post-treatment, the VAS score of the GBP group was statistically lower than that of the GB group (t = 22.441, p <0.001). The clinical efficacy rate of the GBP group was statistically higher than that of the GB group (74.6% vs. 56.7%, p = 0.029). The GBP group had significantly lower serum levels of interleukin (IL)-6, IL-1β, and tumour necrosis factor-α (TNF-α) compared to the GB group (p <0.05). No significant differences were observed in adverse effects between the two groups (46.3% vs. 54.8%, χ2 = 0.478, p = 0.489). Conclusion: The combination therapy with gabapentin and low-dose pregabalin could help reduce pain and inflammatory factors.