Consensus on the Clinical Use of Pregabalin in Peripheral Neuropathic Pain.

Hui Lu, Yuefeng Rao, Jian Wang, Wan Shuanglin, Du Dongping, Ma Ke, Zhiying Feng, Suming Tian, Weidong Qiu, Xu Jing, Zhongwei Zhao, Zhenhua Zeng, Benyan Luo, Changqing Wang, Hui Zhao, Kaiming Liu, Li Lin, Xianfeng Zhang, Gong Liyan, Haiqi Lu, Yan Liu, Qingwei Zhao, Yihe Hu

Journal: CNS neuroscience & therapeutics 2026;32(6):e70866

PMID: 42310848

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Abstract

BACKGROUND

Peripheral neuropathic pain (pNP) is a prevalent and complex clinical condition that presents significant therapeutic challenges, with pharmacological options demonstrating variable efficacy and safety.

OBJECTIVE

To establish expert consensus recommendations on the clinical use of pregabalin in the management of diverse pNP conditions.

METHODS

A multidisciplinary panel of Chinese experts from orthopedics, pain management, neurology, oncology, dermatology, and pharmacy conducted a comprehensive literature review and synthesized clinical evidence to formulate consensus-based recommendations.

RESULTS

Pregabalin, a second-generation calcium channel regulator, demonstrated broad efficacy across multiple pNP conditions, including postherpetic neuralgia (PHN), diabetic peripheral neuropathy (DPN), neuropathic cancer pain (NCP), postoperative and post-traumatic neuralgia, and trigeminal neuralgia (TN). In PHN, pregabalin significantly reduced pain intensity and improved sleep quality. In DPN, it provided consistent analgesia with improved pain scores and good tolerability. In NCP, pregabalin effectively alleviated pain, showed no significant drug-drug interactions, and was safely co-administered with chemotherapy. It was also effective in postoperative and post-traumatic neuralgia, although caution is warranted in cases of traumatic neuroma. In TN, pregabalin exhibited favorable low-dose efficacy, particularly in elderly patients, with minimal adverse effects. However, cautious use is advised in patients with nerve compression syndromes, such as carpal tunnel syndrome, and in individuals with a history of substance abuse.

CONCLUSIONS

This consensus highlights pregabalin as an effective and generally well-tolerated therapeutic option for a broad range of pNP conditions. These recommendations provide clinically relevant guidance for optimizing pregabalin use, particularly within the Chinese healthcare context.

Address: Department of Orthopedics, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.; Department of Clinical Pharmacy, The First Affiliated Hospital, Zhejiang University School of Medicine, Zhejiang Provincial Key Laboratory for Drug Evaluation and Clinical Research, Hangzhou, Zhejiang, China.; Department of Wound Healing, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.; Department of Orthopedics, Zhejiang University School of Medicine Sir Run Run Shaw Hospital, Hangzhou, China.; Department of Pain Management, Shanghai Sixth People's Hospital, Shanghai, China.; Department of Pain Medicine, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, P. R. China.; Department of Pain Medicine, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.; Department of Anesthesia and Pain Medicine, Zhejiang University School of Medicine Sir Run Run Shaw Hospital, Hangzhou, China.; Department of Anesthesia and Pain Medicine, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.; Department of Pain Management, Shanghai Pudong New Area Gongli Hospital, Shanghai, P. R. China.; Department of Pain Medicine, and Key Laboratory of Imaging Diagnosis and Minimally Invasive Intervention Research, Fifth Affiliated Hospital of Wenzhou Medical University, Lishui, Wenzhou, China.; Pain Department, The First People's Hospital of Jiashan, Jiaxing, Zhejiang, China.; Department of Neurology, The First Affiliated Hospital, Zhejiang University School of Medicine, Zhejiang, Hangzhou, China.; Department of Neurology, First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China.; Department of Neurology, Affiliated Drum Tower Hospital of Medical School, Nanjing University, Nanjing, Jiangsu, P. R. China.; Department of Neurology, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.; Department of Endocrinology, Zhejiang University School of Medicine Sir Run Run Shaw Hospital, Hangzhou, China.; Department of Endocrinology, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou, China.; Department of Pain & Rehabilitation Medicine, Zhejiang Cancer Hospital, Hangzhou Institute of Medicine (HIM), Chinese Academy of Sciences, Hangzhou, Zhejiang, China.; Department of Internal Medicine-Oncology, Zhejiang University School of Medicine Sir Run Run Shaw Hospital, Hangzhou, China.; Department of Dermatology, Jiangsu Province Hospital of TCM, Affiliated Hospital of Nanjing University of TCM, Nanjing, China.

DOI: 10.1002/cns.70866

MeSH Terms: Humans, Pregabalin, Neuralgia, Analgesics, Consensus