For patients with partial seizures, pregabalin was not superior to gabapentin in reducing seizure frequency, data from a comparative study published in Neurology has found.

A prestudy modeling demonstrated superior efficacy for pregbabalin compared to gabapentin in reducing seizure frequency. Study authors conducted a comparative efficacy and safety study (n=484) of pregabalin vs. gabapentin as adjunctive treatment in adults with refractory partial-onset seizures in a randomized, flexible dose, double-blind, and parallel group study. There was a 6-week baseline and 21-week treatment phase. The primary endpoint was the percent change from baseline in 28-days seizure rate to the treatment phase. 

Of the total patients, 359 patients (pregabalin=187, gabapentin=172) completed the treatment phase. The median and mean in percentage change from baseline was –58.65 and –47.7 for pregabalin vs. –57.43 and –45.28 for gabapentin. Regarding the primary endpoint, there was no significant difference between treatments. The Hodges-Lehman estimated mean difference was 0.0 (95% CI: -6.0 to 7.0); safety profiles were reported to be comparable and consistent with prior trials. 

Overall, the authors were able to conclude that for patients with partial seizures enrolled in the study, pregabalin was not superior to gabapentin for reducing seizure frequency (Class II evidence). Due to atypical response rates, the study’s findings were poorly generalizable to other epilepsy patient groups. 

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