Efficacy and tolerability of mirogabalin, pregabalin, duloxetine, and placebo in patients with type 2 diabetes mellitus and painful diabetic peripheral neuropathy: A network meta-analysis.
Diabetes Res Clin PractAug 6, 2026 (epub)
Amber Alam, Taha Alam, Muhammad Saad et al.
✦ AI-curated · Sources linked
In 30 seconds
This network meta-analysis evaluated the efficacy and tolerability of mirogabalin, pregabalin, and duloxetine in treating painful diabetic peripheral neuropathy (PDPN) in patients with type 2 diabetes mellitus (T2DM). Analyzing data from 12 randomized controlled trials involving 4,542 participants, duloxetine 120 mg showed the greatest pain reduction (SMD = -0.60; 95% CI: -0.91 to -0.28), while pregabalin demonstrated only modest benefits.
Key findings
- Duloxetine 120 mg achieved the greatest pain reduction (SMD = -0.60; 95% CI: -0.91 to -0.28).
- Mirogabalin 30 mg had a significant >50% responder advantage (OR = 2.13; 95% CI: 1.18 to 3.85).
- Pregabalin 600 mg significantly increased adverse effects (OR = 5.89; 95% CI: 2.00 to 17.33).
- Duloxetine showed a more favorable metabolic safety profile compared to alpha-2-delta ligands.
Why it matters
Understanding the comparative efficacy and safety of these treatments is crucial for clinicians managing painful diabetic peripheral neuropathy in patients with type 2 diabetes, as it informs treatment choices and patient outcomes.