Abstract：
OBJECTIVE: Painful peripheral diabetic neuropathy (PRDN) is a common disabling condition. Pregabalin and amitriptyline are commonly prescribed as the first-line for PPDN despite the contradicting recommendations. There is a need to inform the scientific community regarding first-line pain control among patients with PPDN. This meta-analysis assessed pregabalin and amitriptyline effects on PPDN.
METHODS: We searched PubMed, MEDLINE, Cochrane Library, EBSCO, and Google Scholar; the terms used were amitriptyline, pregabalin, painful diabetic neuropathy, antidepressant, gabapentinoids, quality of life, and adverse events. Boolean operators like AND, and OR were used. Six hundred and thirty-one studies were retrieved, and 37 full texts were screened. However, only six randomized controlled trials fulfilled the inclusion and exclusion criteria.
RESULTS: No significant statistical differences between amitriptyline and pregabalin regarding pain score and significant pain reduction (odd ratio, -0.82, 95% CI, -2.21-0.58, and odd ratio, 1.16, 95% CI, 0.76-1.76 respectively). Quality of life, total adverse events, and drug discontinuation were not different between the two drugs (odd ratio, 0.89, 95% CI, -2.11-3.89, odd ratio, 0.98, 95% CI, 0.52-1.85, and odd ratio, 0.51, 95% CI, 0.08-3.15, respectively).
CONCLUSIONS: No significant statistical differences between amitriptyline and pregabalin regarding their effects on pain and quality of life. The drugs showed similar total adverse events and drug withdrawal. Further larger real-world studies are needed.
METHODS: We searched PubMed, MEDLINE, Cochrane Library, EBSCO, and Google Scholar; the terms used were amitriptyline, pregabalin, painful diabetic neuropathy, antidepressant, gabapentinoids, quality of life, and adverse events. Boolean operators like AND, and OR were used. Six hundred and thirty-one studies were retrieved, and 37 full texts were screened. However, only six randomized controlled trials fulfilled the inclusion and exclusion criteria.
RESULTS: No significant statistical differences between amitriptyline and pregabalin regarding pain score and significant pain reduction (odd ratio, -0.82, 95% CI, -2.21-0.58, and odd ratio, 1.16, 95% CI, 0.76-1.76 respectively). Quality of life, total adverse events, and drug discontinuation were not different between the two drugs (odd ratio, 0.89, 95% CI, -2.11-3.89, odd ratio, 0.98, 95% CI, 0.52-1.85, and odd ratio, 0.51, 95% CI, 0.08-3.15, respectively).
CONCLUSIONS: No significant statistical differences between amitriptyline and pregabalin regarding their effects on pain and quality of life. The drugs showed similar total adverse events and drug withdrawal. Further larger real-world studies are needed.
摘要：
目的：痛苦的周围糖尿病神经病变（PRDN）是一种常见的致残疾病。普瑞巴林和阿米替林通常被规定为PPDN的一线药物，尽管有矛盾的建议。有必要向科学界通报PPDN患者的一线疼痛控制。这项荟萃分析评估了普瑞巴林和阿米替林对PPDN的影响。
方法：我们搜索了PubMed，MEDLINE,科克伦图书馆,EBSCO,和谷歌学者；使用的术语是阿米替林，普瑞巴林,痛苦的糖尿病神经病变，抗抑郁药,gabapentinoids,生活质量,和不良事件。布尔运算符，如AND，或被使用。检索了六百三十一项研究，筛选了37篇全文。然而,只有6项随机对照试验符合纳入和排除标准.
结果：阿米替林和普瑞巴林之间在疼痛评分和显着疼痛减轻方面没有显着统计学差异（奇数比，-0.82，95%CI，-2.21-0.58，奇数比率，1.16，95%CI，分别为0.76-1.76）。生活质量,总不良事件，和停药在两种药物之间没有差异(奇数比率，0.89，95%CI，-2.11-3.89，奇数比率，0.98，95%CI，0.52-1.85，奇数比率，0.51，95%CI，分别为0.08-3.15）。
结论：阿米替林和普瑞巴林对疼痛和生活质量的影响无显著统计学差异。这些药物表现出相似的总不良事件和停药。需要进一步的更大的现实世界研究。
方法：我们搜索了PubMed，MEDLINE,科克伦图书馆,EBSCO,和谷歌学者；使用的术语是阿米替林，普瑞巴林,痛苦的糖尿病神经病变，抗抑郁药,gabapentinoids,生活质量,和不良事件。布尔运算符，如AND，或被使用。检索了六百三十一项研究，筛选了37篇全文。然而,只有6项随机对照试验符合纳入和排除标准.
结果：阿米替林和普瑞巴林之间在疼痛评分和显着疼痛减轻方面没有显着统计学差异（奇数比，-0.82，95%CI，-2.21-0.58，奇数比率，1.16，95%CI，分别为0.76-1.76）。生活质量,总不良事件，和停药在两种药物之间没有差异(奇数比率，0.89，95%CI，-2.11-3.89，奇数比率，0.98，95%CI，0.52-1.85，奇数比率，0.51，95%CI，分别为0.08-3.15）。
结论：阿米替林和普瑞巴林对疼痛和生活质量的影响无显著统计学差异。这些药物表现出相似的总不良事件和停药。需要进一步的更大的现实世界研究。
