アブストラクト | INTRODUCTION: Gabapentinoids (GABA) prescribing as a potential and conceivably safer substitute for opioids has substantially increased. Understanding all potential adverse drug events (ADEs) associated with GABA will guide clinical decision-making for pain management. METHODS: A 20% sample of Medicare enrollees with new chronic pain diagnoses in 2017-2018 was selected. GABA users were those with >=30 consecutive days prescription in a year without opioid prescription. Opioid users were similarly defined. The control group used neither of these drugs. Propensity score match across three groups based on demographics and comorbidity was performed. We used proportional reporting ratio (PRR), Gamma Poisson Shrinker, and tree-based scan statistic (TBSS) to detect ADEs within 3, 6, and 12 months of follow-up. RESULTS: Immunity disorder was detected within 3 months of follow-up by PRR compared to opioid use (PRR:2.33), and by all three methods compared to controls. Complications of transplanted organs/tissues and schizophrenia spectrum/other psychotic disorders were consistently detected by PRR and TBSS within 3 months. Skin disorders were detected by TBSS; and stroke was detected by PRR within 3 months compared to opioid use (PRR:4.74). Some malignancies were detected by PRR within 12 months. Other signals detected in GABA users were neuropathy and nerve disorders. CONCLUSIONS: Our study identified expected and unexpected ADE signals in GABA users. Neurological signals likely related to indications for GABA use. Signals for immunity, mental/behavior, and skin disorders were found in the FDA adverse event reporting system database. Unexpected signals of stroke and cancer require further confirmatory analyses to verify. |
ジャーナル名 | Pharmacoepidemiology and drug safety |
Pubmed追加日 | 2023/8/29 |
投稿者 | Kuo, Yong-Fang; Polychronopoulou, Efstathia; Raji, Mukaila A |
組織名 | Department of Internal Medicine and Sealy Center on Aging, University of Texas;Medical Branch, Galveston, Texas, USA.;Department of Biostatistics and Data Science, University of Texas Medical Branch,;Galveston, Texas, USA.;Office of Biostatistics, University of Texas Medical Branch, Galveston, Texas,;USA. |
Pubmed リンク | https://www.ncbi.nlm.nih.gov/pubmed/37640024/ |