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A meta-analysis published last year showed gabapentinoids to be largely ineffective for chronic low back pain (NEJM JW Gen Med Oct 15 2017 and PLoS Med 2017; 14:1002369). Now, another group has published a somewhat different meta-analysis: It covers anticonvulsants generally, comprises only placebo-controlled trials, and includes trials focused on radiculopathy (in addition to low back pain).
Nine trials (859 total participants) that involved gabapentin, pregabalin, or topiramate were identified. The researchers found “moderate- to high-quality evidence that anticonvulsants are ineffective for treatment of low back pain or lumbar radicular pain.” In addition, they found high-quality evidence that gabapentin and pregabalin are associated with…