Pregabalin relieves pain, itch in recessive dystrophic epidermolysis bullosa

In patients with recessive dystrophic epidermolysis bullosa (RDEB), treatment with pregabalin appears to substantially reduce pain and itch, according to a randomized crossover trial.

The trial included 10 participants with RDEB who were between 8 and 40 years of age and had evidence of probable neuropathic pain and itching, which were defined as distal thermal sensory loss (confirmed by thermal roller), score of at least 4 on the Douleur Neuropathique 4 questionnaire (DN4), and score greater than 4 on a 10-point visual analogue scale (VAS).

The participants were grouped into two and given both pregabalin and matched placebo (titrated to a maximum-tolerated dose of 300 mg/day) in a randomized sequence. Each treatment phase lasted 10 weeks, separated by a 2-week washout period. The main outcome was the difference in the mean pain and itch scores between pregabalin and placebo before and after the intervention.

Group 1 consisted of six patients (mean age 26.7 years, 50 percent female), while group 2 comprised four (mean age 26.5 years, 50 percent female). The sequence of treatment was pregabalin first then placebo in group 1 and placebo first then pregabalin in group 2.

Results showed a significant reduction in pain scores from baseline during the pregabalin vs placebo treatment (mean, –1.9 vs –0.1). Moreover, pregabalin was associated with a mild but significant reduction in itch compared with placebo (mean –0.9 vs –0.1).

In terms of safety, pregabalin was generally well tolerated, with only minor adverse events documented.