Optimising the Therapeutic Window: A Systematic Review and Network Meta‐Analysis of Pregabalin Dosing Strategies for Painful Diabetic Neuropathy
Authors' conclusion
Pregabalin doses ≤ 150 mg/day demonstrated no clinical benefit over placebo. Conversely, both pregabalin 300 and 600 mg/day showed a pain reduction effect at short- and long-term follow-up.
Study context
- Population
- Adults with painful diabetic polyneuropathy (PDPN); databases searched through October 202512 RCTs
- Comparison
- Fixed pregabalin doses vs placebo
- Outcome
- Change in average daily pain score
- Follow-up
- Short and long term
Pooled result
As reported in the abstract
Pain reduction (average daily pain score) · short term
Each group vs placeboSMD (95% CI)
Pregabalin 300 mg/day
1.09(0.69–1.50)
Pregabalin 600 mg/day
0.90(0.24–1.55)
Further pooled results
| Outcome | SMD (95% CI) | |
|---|---|---|
| Pain reduction (average daily pain score) · long termPregabalin 300 mg/dayvs Placebo | 0.12 (0.06–0.17) | |
| Pain reduction (average daily pain score) · long termPregabalin 600 mg/dayvs Placebo | 0.31 (0.23–0.38) | |
| −0.200.20.4Difference (linear scale) |
Pain reduction (average daily pain score) · long term
- Pregabalin 75 and 150 mg/day did not demonstrate superiority over placebo
Safety
- Pregabalin 300 and 600 mg/day associated with greater risks of dizziness, somnolence and peripheral oedema vs pregabalin 75 mg/day, 150 mg/day and placebo
Original publication
Optimising the Therapeutic Window: A Systematic Review and Network Meta‐Analysis of Pregabalin Dosing Strategies for Painful Diabetic Neuropathy. Diabetes Obes Metab. Published 13 April 2026. doi:10.
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