Evidence map›Paper›PMID 41546687›Full record

SynthesisEuropean journal of clinical pharmacology2026

Use of pregabalin and limaprost in the conservative treatment of lumbar spinal stenosis: a systematic review of the current evidence.

Leonardo Di Cosmo, Francesca Romana Centini, Jad El Choueiri, Jordan Hammond, Chiara Learmonth, Leonardo Natale, Francesca Pellicanò, Daniel Uralov, Filippo Emanuele Colella, Ismail Zaed and 1 more

Abstract readSystematic Review
PubMed Publisher
In one paragraph

Synthesis in European journal of clinical pharmacology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Leonardo Di CosmoSchool of Medicine, Humanitas University, Milan, Via Rita Levi Montalcini 4, Pieve Emanuele, 20072, Italy. leonardo.dicosmo@st.hunimed.eu.
Francesca Romana CentiniSchool of Medicine, Humanitas University, Milan, Via Rita Levi Montalcini 4, Pieve Emanuele, 20072, Italy.
Jad El ChoueiriSchool of Medicine, Humanitas University, Milan, Via Rita Levi Montalcini 4, Pieve Emanuele, 20072, Italy.
Jordan HammondSchool of Medicine, Humanitas University, Milan, Via Rita Levi Montalcini 4, Pieve Emanuele, 20072, Italy.
Chiara LearmonthSchool of Medicine, Humanitas University, Milan, Via Rita Levi Montalcini 4, Pieve Emanuele, 20072, Italy.
Leonardo NataleSchool of Medicine, Humanitas University, Milan, Via Rita Levi Montalcini 4, Pieve Emanuele, 20072, Italy.
Francesca PellicanòSchool of Medicine, Humanitas University, Milan, Via Rita Levi Montalcini 4, Pieve Emanuele, 20072, Italy.
Daniel UralovSchool of Medicine, Humanitas University, Milan, Via Rita Levi Montalcini 4, Pieve Emanuele, 20072, Italy.
Filippo Emanuele ColellaSchool of Medicine, Humanitas University, Milan, Via Rita Levi Montalcini 4, Pieve Emanuele, 20072, Italy.
Ismail ZaedDepartment of Neurosurgery, Neurocenter of South Switzerland, EOC, Lugano, Switzerland.
Alessio BaricichDepartment of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BACKGROUND AND

objectivesLumbar spinal stenosis (LSS) is a common degenerative condition and a leading cause of pain and disability in older patients. While conservative treatment options like limaprost, a prostaglandin E1 analog, and pregabalin, a neuropathic pain modulator, are increasingly used, their relative efficacy and safety remain unclear. This systematic review aims to evaluate the comparative efficacy of pregabalin and limaprost in managing pain, function, quality of life, and adverse events in LSS.

methodsA systematic search was conducted following PRISMA guidelines. Searches were performed across PubMed, Embase, Scopus, and Cochrane for studies published between January 2000 and March 2025. Inclusion criteria focused on RCTs and cohort studies evaluating either drug in LSS patients.

resultsNine studies (6 RCTs, 3 cohort studies) with a total of 860 participants were included. Two head-to-head trials found no significant differences between pregabalin and limaprost in improving pain, disability, or quality of life. Both agents were associated with significant within-group improvements. Pregabalin showed efficacy across outcomes when combined with NSAIDs but was consistently associated with a higher frequency of adverse events, primarily including dizziness and gastrointestinal disturbances, compared to limaprost. Limaprost demonstrated mixed results, with several studies reporting benefits primarily when combined with other agents instead of its monotherapy. Evidence on sleep quality outcomes was limited but suggests potential benefits for both drugs in this patient population.

conclusionNo agent demonstrated clear superiority in the treatment of LSS, though both pregabalin and limaprost showed significant within-group benefits. Pregabalin’s greater side effect profile and cost may support preferential use of limaprost in LSS patients. Nevertheless, due to limited comparative trials and substantial heterogeneity in interventions and outcome measures, further high-quality studies are needed to elucidate this non-inferiority and inform clinical guidelines.

Indexed as

AlprostadilAnalgesicsPregabalinSpinal StenosisConservative TreatmentHumansLumbar VertebraeQuality of LifeTreatment OutcomeAlprostadilAnalgesicslimaprostPregabalinConservative treatmentLimaprostLumbar spinal stenosisPregabalin

Identifiers

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.