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After 1 week of single-blinded administration of placebo, 750 patients meeting American College of Rheumatology criteria for fibromyalgia were randomly assigned to pregabalin (300 mg/d, 450 mg/d, 600 mg/d) or placebo, administered twice daily for 14 weeks.

The primary outcome variable was comparison of end point mean pain scores, derived from daily diary ratings of pain intensity (0 to 10 scale), between each of the pregabalin groups and the placebo group. If positive, additional primary efficacy parameters included the Patient Global Impression of Change (PGIC) and the Fibromyalgia Impact Questionnaire (FIQ) total score.

Compared with placebo-treated patients, mean changes in pain scores at the end point in pregabalin-treated patients were significantly greater (P < .001: 300 mg/d, -0.71; 450 mg/d, -0.98; 600 mg/d, -1.00).

Compared with placebo, significantly more pregabalin-treated patients reported improvement on Patient Global Impression of Change PGIC (P < .01 for all 3 pregabalin doses) and significant improvements in total Fibromyalgia Impact Questionnaire score for the 450 mg/d (P = .004) and the 600 mg/d (P = .003) doses.

Compared with placebo, all 3 doses of pregabalin were associated with significant improvement in sleep.

The most commonly reported pregabalin-related adverse events were dizziness and somnolence, which tended to be dose-related.

Perspective: This randomized, placebo-controlled trial of 300, 450, and 600 mg/d of pregabalin monotherapy demonstrated that all 3 doses were efficacious for up to 14 weeks for the treatment of fibromyalgia and were well tolerated by most patients. These results provide evidence that pregabalin is an important treatment option for patients with fibromyalgia.

Source: The Journal of Pain. Jun 2, 2088. [Epub ahead of print] PMID: 18524684, by Arnold LM, Russell IJ, Diri EW, Duan WR, Young JP Jr, Sharma U, Martin SA, Barrett JA, Haig G. University of Cincinnati College of Medicine, Cincinnati, Ohio, USA.