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Clinical Characteristics, Pharmacotherapy and Healthcare Resource Use among Patients with Fibromyalgia Newly Prescribed Gabapentin or Pregabalin – Source: Pain Practice, Jun 4, 2009

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By Mugdha Gore, PhD, B.Pharm, Daniel J Clauw, MD, et al. • www.ProHealth.com • June 9, 2009


[Note: Pregabalin (Lyrica) and gabapentin (neurontin) are both anticonvulsants also used for neuropathic pain. Pregabalin is FDA approved for treatment of fibromyalgia.]

Objective: To characterize comorbidities, pain-related pharmacotherapy, and healthcare resource use among patients with fibromyalgia (FM) newly prescribed pregabalin or gabapentin in clinical practice.

Methods and design: Using the PharMetrics((R)) Database, FM patients (International Classification of Diseases, Ninth Revision, Clinical Modification code 729.1X) newly prescribed pregabalin (n = 1,606; mean age 49.9 +/- 9.6 years; 87.9% female) and gabapentin (n = 930; mean age 49.5 +/- 9.6 years; 86.6% female) on/after July 1, 2007 were identified.

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.

Results:

Patients in both cohorts had a variety of comorbidities and used multiple medications.

There were significant decreases (P values < 0.05) 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 cohort in the postindex period.

There were significant increases (all P values < 0.05) in 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 cohort.

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 pregabalin,

• And office visits and medication costs for gabapentin (all P values < 0.05).

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

Source: Pain Practice, Jun 4, 2009. PMID: 19500273, by Gore M, Sadosky AB, Zlateva G, Clauw DJ. Avalon Health Solutions, Inc., Philadelphia, Pennsylvania; Pfizer, Inc.—Global Outcomes Research, New York, New York; ‡ Department of Anesthesiology and Medicine, University of Michigan, Ann Arbor, Michigan, U.S.A. [E-mail: Mugdha Gore mgore@avalonhealthsolutions.com]





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