A COMPARATIVE ANALYSIS OF EFFICACY AND SAFETY OF PREGABALIN VERSUS DULOXETINE IN MANAGING DIABETIC NEUROPATHY

Background: Diabetic neuropathy is a common complication of diabetes mellitus, often leading to significant morbidity and impaired quality of life. Pharmacological management includes agents such as pregabalin and duloxetine, but comparative evidence on their efficacy and safety remains limited in local populations. Objective: To compare the efficacy and safety of pregabalin versus duloxetine in the management of diabetic neuropathy at Lady Reading Hospital, Peshawar. Study Design: Randomized controlled trial. Setting: Department of Medicine, Lady Reading Hospital, Peshawar, Pakistan. Duration of Study: 05-December-2024 to 05-June-2025. Methods: A total of 160 patients aged 30–75 years with confirmed diabetes mellitus and clinically diagnosed diabetic neuropathy were randomly assigned to two equal groups. Group A received pregabalin (300 mg/day) and Group B received duloxetine (60 mg/day). Efficacy was evaluated by improvement in neuropathic symptoms and physical examination findings. Safety was assessed based on the occurrence of adverse events, including constipation, decreased appetite, and lethargy. Statistical analysis was performed using SPSS version 25, with chi-square and t-tests applied as appropriate; p-values <0.05 were considered statistically significant. Results: In the duloxetine group, 77.5% of patients achieved symptomatic improvement compared to 61.2% in the pregabalin group (p < 0.05). Adverse event profiles were comparable between the two groups. Pregabalin was associated with a higher incidence of lethargy (11.2%), while duloxetine had slightly more cases of constipation (7.5%), with no statistically significant difference (p > 0.05). Conclusion: Duloxetine demonstrated significantly greater efficacy than pregabalin in managing diabetic neuropathy, while both drugs exhibited similar safety profiles. Duloxetine may be considered a preferred option in this patient population.