Trial of Pregabalin for Acute and Chronic Sciatica- The PRECISE Study

Mathieson. NEMJ 2017; 376:1111-1121. doi:10.1056/NEJMoa1614292

Clinical Question

• In patients with moderate-to-severe sciatica, does pregabalin compared to placebo reduce leg pain?
  N = 209, 47 outpatient centres in NSW Australia

Authors’ Conclusions

• Pregabalin did not relieve sciatic pain or improve related clinical measures, as compared with placebo, over the course of 8 weeks.
• Pregabalin was associated with higher rates of adverse events than placebo.

The Bottom Line

• This trial provides evidence that pregabalin is not more effective than placebo for reducing leg pain in patients with sciatica
• Given the methodological weaknesses of this trial and in the absence of any other effective therapies, clinicians may choose to prescribe pregabalin in patients presenting acutely with severe sciatic back pain, however, the reported increase in adverse effects means that it should be used with caution