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.

Mean age was 57.7 years; HbA1c 7.6% and moderate baseline pain severity.

Pregabalin showed only modest benefits (flexible dosing; SMD = -0.21; 95% CI: -0.42 to -0.01).

Mirogabalin 30 mg alone achieved 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); weight gain and edema were elevated with both alpha-2-delta (α2δ) ligands, and somnolence occurred across agents.