Cochrane · systematic review · CD005612
Pregabalin add‐on for drug‐resistant focal epilepsy
Panebianco, M, Bresnahan, R, Marson, AG · Cochrane Database of Systematic Reviews · 2022 · Cochrane Library
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
26
current version
GRADE rated
26
No studies
0
Included studies
NR
No studies 0 · 0%Ungraded 0 · 0%Very low 7 · 26.9%Low 15 · 57.7%Moderate 4 · 15.4%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Current version onlyPregabalin compared to placebo for drug‐resistant focal epilepsy
Population: drug‐resistant focal epilepsy
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
50% or greater reduction in seizure frequency ‐ ITT analysis Pregabalin vs placebo | RR 1.95 [1.4, 2.72] | 9 studies · 2663 participants | Low Downgraded: risk of bias, inconsistency, publication bias |
50% or greater reduction in seizure frequency ‐ best‐case analysis Pregabalin vs placebo | RR 2.91 [1.92, 4.42] | 9 studies · 2663 participants | Very low Downgraded: risk of bias, inconsistency, publication bias |
50% or greater reduction in seizure frequency ‐ worst‐case analysis Pregabalin vs placebo | RR 1.1 [0.92, 1.31] | 9 studies · 2663 participants | Very low Downgraded: risk of bias, inconsistency, publication bias |
Seizure freedom Pregabalin vs placebo | 3.94 [1.5, 10.37] | 4 studies · 1125 participants | Moderate Downgraded: risk of bias, imprecision |
Treatment withdrawal for any reason Pregabalin vs placebo | RR 1.33 [1.1, 1.6] | 9 studies · 2663 participants | Moderate Downgraded: risk of bias |
Treatment withdrawal due to adverse effects Pregabalin vs placebo | RR 2.6 [1.86, 3.64] | 9 studies · 2663 participants | Moderate Downgraded: risk of bias, imprecision |
Adverse effect: ataxia Pregabalin vs placebo | RR 3.9 [2.05, 7.42] | 6 studies · 1868 participants | Low Downgraded: risk of bias |
Adverse effect: dizziness Pregabalin vs placebo | RR 3.15 [2.23, 4.44] | 7 studies · 2193 participants | Low Downgraded: risk of bias |
Adverse effect: fatigue Pregabalin vs placebo | RR 1.35 [0.94, 1.93] | 8 studies · 2448 participants | Low Downgraded: risk of bias |
Adverse effect: headache Pregabalin vs placebo | RR 0.65 [0.45, 0.94] | 6 studies · 1850 participants | Very low Downgraded: risk of bias, inconsistency, publication bias |
Adverse effect: nausea Pregabalin vs placebo | RR 1.2 [0.56, 2.58] | 4 studies · 1267 participants | Low Downgraded: risk of bias |
Adverse effect: somnolence Pregabalin vs placebo | RR 2.05 [1.49, 2.81] | 9 studies · 2663 participants | Low Downgraded: risk of bias |
Adverse effect: weight gain Pregabalin vs placebo | RR 4.35 [2.34, 8.11] | 8 studies · 2488 participants | Low Downgraded: risk of bias |
Pregabalin compared to active comparators for drug‐resistant focal epilepsy
Population: drug‐resistant focal epilepsy
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
50% or greater reduction in seizurefrequency Pregabalin vs active comparators | RR 1.03 [0.85, 1.25] | 3 studies · 1286 participants | Low Downgraded: risk of bias, imprecision, inconsistency |
50% or greater reduction in seizure frequency ‐ best‐case analysis Pregabalin vs active comparators | RR 1.6 [1.17, 2.19] | 3 studies · 1286 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
50% or greater reduction in seizure frequency ‐ worst‐case analysis Pregabalin vs active comparators | RR 0.67 [0.62, 0.74] | 3 studies · 1286 participants | Moderate Downgraded: risk of bias, imprecision |
Seizure freedom Pregabalin vs active comparators | RR 0.59 [0.37, 0.95] | 2 studies · 802 participants | Very low Downgraded: risk of bias, imprecision |
Treatment withdrawal for any reason Pregabalin vs active comparators | RR 0.93 [0.76, 1.13] | 3 studies · 1286 participants | Low Downgraded: risk of bias, imprecision |
Treatment withdrawal for adverse events Pregabalin vs active comparators | 1.04 [0.73, 1.48] | 3 studies · 1286 participants | Low Downgraded: risk of bias, imprecision |
Adverse effect: ataxia Pregabalin vs active comparators | 1.72 [0.54, 5.55] | 1 study · 293 participants | Low Downgraded: risk of bias, imprecision |
Adverse effect: dizziness Pregabalin vs active comparators | 1.64 [0.85, 3.16] | 3 studies · 1286 participants | Low Downgraded: risk of bias, imprecision |
Adverse effect: fatigue Pregabalin vs active comparators | 1.72 [0.77, 3.83] | 1 study · 293 participants | Low Downgraded: risk of bias, imprecision |
Adverse effect: headache Pregabalin vs active comparators | 0.83 [0.41, 1.65] | 3 studies · 1286 participants | Very low Downgraded: risk of bias, imprecision |
Adverse effect: nausea Pregabalin vs active comparators | 0.2 [0.04, 1.01] | 1 study · 509 participants | Very low Downgraded: risk of bias, imprecision |
Adverse effect: somnolence Pregabalin vs active comparators | 1.16 [0.88, 1.53] | 3 studies · 1286 participants | Low Downgraded: risk of bias, imprecision |
Adverse effect: weight gain Pregabalin vs active comparators | 2.87 [0.94, 8.75] | 3 studies · 1286 participants | Low Downgraded: risk of bias, imprecision |
Pregabalin compared to placebo for drug‐resistant focal epilepsy
Population: drug‐resistant focal epilepsy
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
50% or greater reduction in seizure frequency ‐ ITT analysis Pregabalin vs placebo | RR 2.28 [1.52, 3.42] | 7 studies · 2193 participants | Low Downgraded: risk of bias, inconsistency, publication bias |
50% or greater reduction in seizure frequency ‐ best‐case analysis Pregabalin vs placebo | RR 3.57 [2.17, 5.86] | 7 studies · 2193 participants | Very low Downgraded: risk of bias, inconsistency, publication bias |
50% or greater reduction in seizure frequency ‐ worst‐case analysis Pregabalin vs placebo | RR 1.15 [0.92, 1.43] | 7 studies · 2193 participants | Very low Downgraded: risk of bias, inconsistency |
Seizure freedom Pregabalin vs placebo | RR 3.94 [1.5, 10.37] | 4 studies · 1125 participants | Moderate Downgraded: risk of bias, imprecision |
Treatment withdrawal for any reason Pregabalin vs placebo | RR 1.35 [1.11, 1.65] | 7 studies · 2193 participants | Moderate Downgraded: risk of bias |
Treatment withdrawal due to adverse effects Pregabalin vs placebo | RR 2.65 [1.88, 3.74] | 7 studies · 2193 participants | Moderate Downgraded: risk of bias, imprecision |
Pregabalin compared to active comparators for drug‐resistant focal epilepsy
Population: drug‐resistant focal epilepsy
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
50% or greater reduction in seizure frequency Pregabalin vs active comparators | RR 1.03 [0.85, 1.25] | 3 studies · 1286 participants | Low Downgraded: risk of bias, imprecision |
50% or greater reduction in seizure frequency ‐ best‐case analysis Pregabalin vs active comparators | RR 1.6 [1.17, 2.19] | 3 studies · 1286 participants | Very low Downgraded: risk of bias, imprecision |
50% or greater reduction in seizure frequency ‐ worst‐case analysis Pregabalin vs active comparators | RR 0.67 [0.62, 0.74] | 3 studies · 1286 participants | Moderate Downgraded: risk of bias, imprecision |
Seizure freedom Pregabalin vs active comparators | RR 0.59 [0.37, 0.95] | 2 studies · 802 participants | Very low Downgraded: risk of bias, imprecision |
Treatment withdrawal for any reason Pregabalin vs active comparators | RR 0.93 [0.76, 1.13] | 3 studies · 1286 participants | Low Downgraded: risk of bias, imprecision |
Treatment withdrawal for adverse events Pregabalin vs active comparators | RR 1.04 [0.73, 1.48] | 3 studies · 1286 participants | Low Downgraded: risk of bias, imprecision |
Pregabalin versus placebo: 50% seizure reduction ‐ ITT for drug‐resistant partial epilepsy
Population: patients with drug‐resistant partial epilepsy
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
50% responders, ITT ‐ any dose pregabalin Pregabalin vs placebo: 50% seizure reduction ‐ ITT | RR 2.61 [1.7, 4.01] | 6 studies · 1868 participants | Moderate Downgraded: inconsistency |
Pregabalin versus placebo: 50% seizure reduction ‐ ITT for drug‐resistant partial epilepsy
Population: patients with drug‐resistant partial epilepsy
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
50% responders, ITT ‐ any dose pregabalin Pregabalin vs placebo: 50% seizure reduction ‐ ITT | RR 2.61 [1.7, 4.01] | 6 studies · 1868 participants | Moderate Downgraded: inconsistency |