Fibromyalgia Syndrome Patients Newly Prescribed Gabapentin or Pregabalin

A study, e-published ahead of print in Pain Practice, the official journal of the World Institute of Pain, has found that Fibromyalgia Syndrome patients newly prescribed with either pregabalin or gabapentin tend to have an increase in the cost of their healthcare.

The study aimed to characterise comorbidities, pain-related pharmacotherapy, and healthcare resource use among patients with Fibromyalgia Syndrome (Fibro) newly prescribed pregabalin or gabapentin in clinical practice.

Using the PharMetrics Database, Fibro patients who had been newly prescribed pregabalin and gabapentin on or after July 1, 2007 were identified. There were 1,606 patients newly prescribed pregabalin, of which 87.9% were female, with an average age of 49.9 years +/- 9.6 years. And there were 930 patients newly prescribed gabapentin, of which 86.6% were female, with an average age of 49.5 years +/- 9.6 years.

Prevalence of comorbidities, pharmacotherapy, and healthcare resource use/costs (pharmacy, outpatient, inpatient, total) were examined during the 6 months preceding (preindex) and following (postindex) the date of their first pregabalin or gabapentin (index) prescription.

The study found that patients in both groups had a variety of comorbidities and used multiple medications.

There were significant decreases in the use of nonsteroidal anti-inflammatory drugs (32.1% vs. 29.5%), anticonvulsants (27.0% vs. 22.0%), and combination therapies in the pregabalin group in the postindex period.

However there were significant increases in the use of short-acting opioids (58.8% vs. 63.7%), any opioids (61.5% vs. 65.6%), serotonin-norepinephrine reuptake inhibitors (22.5% vs. 24.5%), anticonvulsants (16.3% vs. 26.2%), benzodiazepines (33.2% vs. 36.6%), topical agents (6.6% vs. 9.0%), and combination therapies in the gabapentin group.

Although there were no changes in units of healthcare resources used, there were increases in the postindex period in hospitalization, medications, and total costs for the pregabalin group, and in office visits and medication costs for the gabapentin group.

In conclusion:

"Results suggest a high comorbidity and medication use burden in [Fibro] patients in this study. Further evaluation is warranted to clarify differences in resource utilization/costs observed with these two anticonvulsants. "

References:

1. Gore M, Sadosky AB, Zlateva G, Clauw DJ. Clinical Characteristics, Pharmacotherapy and Healthcare Resource Use among Patients with Fibromyalgia Newly Prescribed Gabapentin or Pregabalin. Pain Pract. 2009 Jun 4. [Epub ahead of print]