← Evidence libraryPRECISE (pregabalin for sciatica)
Trial of Pregabalin for Acute and Chronic Sciatica
Mathieson S, Maher CG, McLachlan AJ, et al. The New England journal of medicine 2017 · PMID 28328324 · doi:10.1056/nejmoa1614292
Randomised trialManagementSpineCitation checked
- Question
- Does pregabalin reduce leg pain in patients with acute or chronic sciatica?
- Design
- Double-blind placebo-controlled RCT in Australia.
- Patients
- Adults with moderate to severe sciatica of between 1 week and 1 year duration.
- Intervention
- Pregabalin titrated up to 600 mg/day
- Comparison
- Placebo
- Primary outcome
- Leg pain intensity at 8 weeks
- Key result
- Pregabalin did not significantly reduce leg pain compared with placebo at 8 weeks or at 1 year, and caused more adverse events such as dizziness.
- Limitations
- Did not test other neuropathic agents and included a heterogeneous mix of acute and chronic sciatica.
- Impact on practice
- Underpins NICE NG59 advice not to offer gabapentinoids for sciatica, alongside concerns over misuse and controlled-drug status.