A muscle cramp is associated with peripheral nerve hyperexcitability (PNH) and is one of the most debilitating symptoms frequently discovered in patients with liver cirrhosis. A recent study investigated if pregabalin can suppress neuronal excitability and reduce muscle cramps in cirrhotic patients.

The study enrolled participants with cirrhosis from a single tertiary center. The primary endpoint was the relative change in cramp frequency from the run-in to the standard dose treatment phase (4 weeks/each), while the Secondary endpoints included the responder rate, and the changes in cramp frequency during sleep, pain intensity, health-related quality of life (Liver Disease Quality of Life Instrument, Short Form-36) and electrophysiological measures of PNH.

The study was terminated early due to insufficient accrual. 80% of the target number of participants were randomized to pregabalin or placebo. The median baseline frequency of muscle cramps was 5.8/week in the pregabalin group and 6.5 in the placebo group. The primary analysis revealed a significant reduction in cramp frequency with pregabalin compared to placebo. Secondary outcomes were not significantly different between the two groups. Adverse effects observed with pregabalin were primarily dizziness and lethargy.

These results indicate an acceptable safety profile and a favorable effect of pregabalin in reducing muscle cramps than placebo in patients with cirrhosis.

 Ahn S, Hong Y-H, Lee DH, et al., Efficacy and Safety of Pregabalin for Muscle Cramps in Liver Cirrhosis: A Double-Blind Randomized Controlled Trial. Journal of Korean Medical Science 2022; 37(7): e56. DOI: https://doi.org/10.3346/jkms.2022.37.e56