JPSIM Journal of Pakistan Society of Internal Medicine J Pak Soc Intern Med 2709-8729 2710-0804 Pakistan Society of Internal Medicine 10.70302/jpsim.v2i1.2110 jpsim.v2i1.2110 Original Research Efficacy of Pregabalin Versus Duloxetine in Patients with Diabetic Painful Neuropathy Shafi Yasir Khan Ali Asad Mumtaz Sami Ullah drsummumtaz@gmail.com * Akram Rabia Qayyum Sadia Abaidullah Sajid King Edward Medical University / Mayo Hospital Lahore *Correspondence: Sami Ullah Mumtaz (drsummumtaz@gmail.com) 13 03 2021 2021 2 1 33 36 28 11 2020 09 01 2021 Copyright © 2021 The Author(s) 2021 The Author(s) https://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Background

Diabetic neuropathy occurs in 30% of patients and presents with paraesthesia in the feet, cutaneous hyperaesthesia and abnormal gait. There is a difference in opinion regarding the first line agents for painful diabetic neuropathy.

 Objective

The objective of the study was to compare the efficacy of pregabalin and duloxetine in terms of good pain relief in patients with diabetic neuropathy.

 Methodology

This randomized controlled trial was conducted in 116 patients after an informed consent. VAS was used to assess the baseline pain level and the patients were allocated to either group A (Pregabalin group; 150mg twice a day) or group B (Duloxetine group; 60mg once a day) for up to 6 weeks using single blind technique and lottery method. Patients were assessed at weeks 3 and 6 to assess the relief in pain.

 Results

Mean age in both the groups was 48.36+7.10 and 50.56+6.17 respectively. Mean pain (VAS) at baseline in both the groups were 6.44+0.92 and 7.22+0.46 respectively whereas mean pain (VAS) at 06 weeks were 4.0+0.60 and 5.04+0.57 respectively. Frequency and percentage of good pain relief was 33(66%) and 37(74%) respectively (p = 0.383). Among the patients who reported good pain relief, 70 were male while 4 were female patients and out of those 26 patients that did not meet the criteria for good pain relief, 11 were male and 15 patients were female.

 Conclusion

The study concluded that both duloxetine and pregabalin were equally effective in diabetic painful neuropathy with variable results in male and female patients.

 Keywords Diabetic Neuropathy Pregabalin Duloxetine. References Iqbal Z, Azmi S, Yadav R, Ferdousi M, Kumar M , Cuthbertson DJ, et al. Diabetic Peripheral Neuropathy: Epidemiology, Diagnosis, and Pharmacotherapy. Clin Ther. 2018;40(6):828-49. Cristian AB, Remus AP. Diabetic Neuropathy Prevalence and Its Associated Risk Factors in Two Representative Groups of Type 1 and Type 2 Diabetes Mellitus Patients from Bihor County. Maedica. 2018;13(3):229-34. Bansal D, Gudala K, Muthyala H, Esam HP, Nayakallu R, Bhansali A. Prevalence and risk factors of development of peripheral diabetic neuropathy in type 2 diabetes mellitus in a tertiary care setting. J Diabetes Investig. 2014;5(6):714-21. Ang L, Codwin N, Mizokami-Stout K, Pop-Busui R. Update on the Management of Diabetic Neuropathy. Diabetes Spectr. 2018;31(3):224-33. Javed S, Petropoulos IN, Alam U, Malik RA. Treatment of painful diabetic neuropathy. Ther Adv Chronic Dis. 2015;6(1):15-28. Happich M, Schneider E, Boess FG, Wihelm S, Schaht A, Birklein F, et al. Effectiveness of duloxetine compared with pregabalin and gabapentin in diabetic peripheral neuropathic pain: results from a German observational study. Clin J Pain. 2014;30(10):875-85. Pop-Busui R, Boulton AJ, Feldman EL, Bril V, Freeman R, Malik RA, et al. Diabetic neuropathy, a position statement by the American diabetes association. Diabetes Care. 2017;40(1):136-42. Jaiswal M, Divers J, Dabelea D, Isom S, Bell RA, Martin CL, Pettitt DJ, et al. Prevalence of and Risk Factors for Diabetic Peripheral Neuropathy in Youth With Type 1 and Type 2 Diabetes: SEARCH for Diabetes in Youth Study. Diabetes Care. 2017;40(9):1226-1232. Gibbons CH, Freeman R. Treatment-induced neuropathy of diabetes: an acute, iatrogenic complication of diabetes. Brain. 2015;138(1):43-52. Carlos F, Espejel L, Novick D, Lopez R, Flores D. Duloxetine for the treatment of painful diabetic peripheral neuropathy in Venezuela: economic evaluation. Medwave. 2015;15(8):265-9. Shahid W, Kumar R, Shaikh A, Kumar S, Jameel R, Fareed S. Comparison of the Efficacy of Duloxetine and Pregabalin in Pain Relief Associated with Diabetic Neuropathy. Cureus. 2019;11(7):122-6. Hossain SM, Hussain SM, Ekram AR. Duloxetine in painful diabetic neuropathy: a systemic review. Clin J Pain. 2016;32(11):1005-10. Arshad I, Zulfiqar H, Shafi B. To compare the efficicacy of Pregablin and Amitriptyline for pain relief in patients with diabetic peripheral neuropathy. J. Pion Med Sc. 2018;8(2):245-52. Devi P, Madhu K, Ganapathy B, Sarma G, John L, Kulkarni C. Evaluation of efficacy and safety of gabapentin, duloxetine, and pregabalin in patients with painful diabetic peripheral neuropathy. Indian J Pharm. 2012;44(1):51. Javed S, Petropoulos IN, Alam U, Malik RA. Treatment of painful diabetic neuropathy. Therapeutic advances in chronic disease. 2015;6(1):15–28.