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Safety and efficacy of two pregabalin regimens for add-on treatment of partial epilepsy

From the University of Michigan Health System (Dr. Beydoun) and Pfizer Global Research and Development (Drs. Kugler, Knapp, and Garofalo, M.J. Greiner), Ann Arbor Laboratories, Pfizer Inc., Ann Arbor, MI, and North Florida/South Georgia Veterans Health System and University of Florida College of Medicine and McKnight Brain Institute (Dr. Uthman), Gainesville, FL.

Address correspondence and reprint requests to Dr. A. Beydoun, University of Michigan Health System, 1500 E. Medical Center Dr., UH 1 B 300/0036, Ann Arbor, MI 48109-0036; e-mail: beydoun{at}umich.edu

Objective: To evaluate the efficacy, tolerability, and safety of two pregabalin regimens administered as adjunctive therapy to that of placebo in patients with medically refractory partial epilepsy.

Methods: A multicenter, double-blind, randomized, parallel-group, placebo-controlled trial was performed. Following a prospective 8-week baseline phase, patients were randomized to 12 weeks of double-blind treatment with placebo or pregabalin 600 mg/day administered twice daily (BID) or three times daily (TID). Primary efficacy was measured as change in seizure frequency from baseline of either pregabalin regimen compared with placebo. Secondary efficacy comparisons included the proportion of patients experiencing 50% reduction in seizure frequency (responder rate) and median percentage change from baseline in seizure frequency. Safety/tolerability assessments included adverse events (AEs), physical and neurologic examinations, and clinical laboratory evaluation. Efficacy and safety analyses were performed on the intent-to-treat (ITT) population.

Results: Pregabalin treatment resulted in seizure frequency reductions: 53% for pregabalin TID (p 0.0001) and 44% for pregabalin BID (p 0.0001) compared with a 1% increase for placebo. Responder rates were 49% for pregabalin TID and 43% for pregabalin BID compared with 9% for placebo (p 0.001). Both pregabalin regimens were similar in efficacy and tolerability. The most common AEs were dizziness, somnolence, and ataxia.

Conclusions: Pregabalin administered at 600 mg/day is safe, generally well tolerated, and efficacious as adjunctive therapy for the treatment of patients with partial seizures, with or without secondary generalizations. This dose can be administered on a twice daily or three times daily schedule with similar efficacy and tolerability results.

Supported by Pfizer Inc.

Received January 17, 2003. Accepted in final form October 22, 2004.

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