Recent prescription status of oral analgesics in Japan in real-world clinical settings: retrospective study using a large-scale prescription database

Ushida, Takahiro; Matsui, Daiju; Inoue, Teruyoshi; Yokoyama, Mika; Takatsuna, Hiroshi; Matsumoto, Teruyuki; Takita, Atsushi; Kurusu, Takao; Sakoda, Hiroshi; Okuizumi, Kaoru

doi:10.1080/14656566.2019.1651840

Cited by 26 publications

(37 citation statements)

References 20 publications

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“…Similarly, 34% had just one single dispensed prescription for various indications, including epilepsy, generalized anxiety disorder, and neuropathic pain, indicating only 64% had further refills after the first prescription in Sweden (16). Besides, according to an Israeli study in fibromyalgia, the median time to discontinuation for antiepileptics, namely pregabalin and gabapentin, was 30 days (IQR 30-106 days) (17), and the mean prescription duration of pregabalin for pain was 52.2 days in a Japanese real-word study (18). In the present study, the persistence rates were 29.3% and 12.1% at 90 days and one year, respectively, indicating only a minority of patients continued to use pregabalin.…”

Section: Discussionmentioning

confidence: 99%

Persistence of Pregabalin Treatment in Taiwan: a Nation-Wide Population-Based Study

Wang

Chen

Tsai

et al. 2020

Preprint

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Background Pregabalin is approved for the treatment of neuropathic pain, fibromyalgia, and seizure disorders, although the pivotal trials were mostly carried out in Europe or North America. The prescribing patterns among different indications in Asia have rarely been explored. Methods This was a population-based retrospective cohort study based on the National Health Insurance Research Database in Taiwan. Prescriptions of pregabalin were identified, and data regarding demographics, indications, co-existing diagnoses, and concomitant medications were extracted. Pregabalin users were followed for at least one year, and factors associated with persistence at one year were determined by using multivariate logistic regression analysis. Results Between June 2012 and December 2016, 114,437 pregabalin users (mean age 60.7±15.4 years, 57.8% female) were identified. The indications included post-herpetic neuralgia (PHN) (30.5%), musculoskeletal diseases other than fibromyalgia (21.2%), fibromyalgia (18.4%), diabetic peripheral neuropathic pain (DPNP) (11.7%) and epilepsy (2.9%). Overall, 62.5% and 6.4% of patients achieved a maximum dose of ≥150 and ≥300 mg/day, respectively. The median duration of persistent pregabalin use was 28 days (interquartile range 14-118 days). The one-year persistence rate was 12.1%, and the indications associated with the highest and lowest persistence rates were epilepsy (42.4%) and PHN (6.1%), respectively. Male gender (odds ratio [OR] 1.14, 95% confidence interval [CI] 1.09-1.18), older age (OR 1.01 per year, 95% CI 1.01-1.01), indications other than PNH, especially epilepsy (OR 8.04, 95% CI 7.33-8.81, PHN as reference), and a higher initial dose (OR 1.12 per 75 mg, 95% CI=1.10-1.15) were associated with persistence at one year, whereas the initial concomitant use of antiviral agents decreased the likelihood (OR 0.41, 95% CI 0.35-0.47). Conclusions Pregabalin prescriptions for pain disorders were limited to short-term use, which is consistent around the world. However, the average prescribed dose in Taiwan was lower than those in Western countries, and was typically below the recommended ranges. Potential causes included off-label prescriptions for pain in acute herpes zoster, rather than PNH, as well as intolerance to the side effects. Keywords pregabalin, pain, persistence

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Section: Discussionmentioning

confidence: 99%

Persistence of Pregabalin Treatment in Taiwan: a Nation-Wide Population-Based Study

Wang

Chen

Tsai

et al. 2020

Preprint

View full text Add to dashboard Cite

show abstract

“…Similarly, 34% had just one single dispensed prescription for various indications, including epilepsy, generalized anxiety disorder, and neuropathic pain, indicating only 64% had further refills after the first prescription in Sweden [17]. Besides, according to an Israeli study in fibromyalgia, the median time to discontinuation for antiepileptics, namely pregabalin and gabapentin, was 30 days (IQR 30-106 days) [18], and the mean prescription duration of pregabalin for pain was 52.2 days in a Japanese retrospective realworld study [19]. In addition, similar findings were reported in prospective real-world studies involving patients with NeP.…”

Section: Discussionmentioning

confidence: 99%

Persistence of pregabalin treatment in Taiwan: a nation-wide population-based study

et al. 2020

View full text Add to dashboard Cite

Background: Pregabalin is approved for the treatment of neuropathic pain, fibromyalgia, and seizure disorders, although the pivotal trials were mostly carried out in Europe or North America. The prescribing patterns among different indications in Asia have rarely been explored. Methods: This was a population-based retrospective cohort study based on the National Health Insurance Research Database in Taiwan. Prescriptions of pregabalin were identified, and data regarding demographics, indications, coexisting diagnoses, and concomitant medications were extracted. Pregabalin users were followed for at least one year, and factors associated with persistence at one year were determined by using multivariate logistic regression analysis. Results: Between June 2012 and December 2016, 114,437 pregabalin users (mean age 60.7 ± 15.4 years, 57.8% female) were identified. The indications included post-herpetic neuralgia (PHN) (30.5%), musculoskeletal diseases other than fibromyalgia (21.2%), fibromyalgia (18.4%), diabetic peripheral neuropathic pain (DPNP) (11.7%) and epilepsy (2.9%). Overall, 62.5% and 6.4% of patients achieved a maximum dose of ≥150 and ≥ 300 mg/day, respectively. The median duration of persistent pregabalin use was 28 days (interquartile range 14-118 days). The one-year persistence rate was 12.1%, and the indications associated with the highest and lowest persistence rates were epilepsy (42.4%) and PHN (6.1%), respectively. Male gender (odds ratio [OR] 1.14, 95% confidence interval [CI] 1.09-1.18), older age (OR 1.01 per year, 95% CI 1.01-1.01), indications other than PHN, especially epilepsy (OR 8.04, 95% CI 7.33-8.81, PHN as reference), and a higher initial dose (OR 1.12 per 75 mg, 95% CI = 1.10-1.15) were associated with persistence at one year, whereas the initial concomitant use of antiviral agents decreased the likelihood (OR 0.41, 95% CI 0.35-0.47). Conclusions: Pregabalin prescriptions for pain disorders were limited to short-term use, which is consistent around the world. However, the average prescribed dose in Taiwan was lower than those in Western countries, and was frequently below the recommended ranges. Potential causes included the duration of natural history of PHN, and off-label prescriptions for pain in acute herpes zoster, rather than PHN, as well as intolerance to the side effects.

show abstract

“…Similarly, 34% had just one single dispensed prescription for various indications, including epilepsy, generalized anxiety disorder, and neuropathic pain, indicating only 64% had further refills after the first prescription in Sweden (17). Besides, according to an Israeli study in fibromyalgia, the median time to discontinuation for antiepileptics, namely pregabalin and gabapentin, was 30 days (IQR 30-106 days) (18), and the mean prescription duration of pregabalin for pain was 52.2 days in a Japanese retrospective real-world study (19). In addition, similar findings were reported in prospective real-world studies involving patients with NeP.…”

Section: Discussionmentioning

confidence: 99%

Persistence of Pregabalin Treatment in Taiwan: a Nation-Wide Population-Based Study

Wang

Chen

Tsai

et al. 2020

Preprint

View full text Add to dashboard Cite

Background Pregabalin is approved for the treatment of neuropathic pain, fibromyalgia, and seizure disorders, although the pivotal trials were mostly carried out in Europe or North America. The prescribing patterns among different indications in Asia have rarely been explored.Methods This was a population-based retrospective cohort study based on the National Health Insurance Research Database in Taiwan. Prescriptions of pregabalin were identified, and data regarding demographics, indications, co-existing diagnoses, and concomitant medications were extracted. Pregabalin users were followed for at least one year, and factors associated with persistence at one year were determined by using multivariate logistic regression analysis.Results Between June 2012 and December 2016, 114,437 pregabalin users (mean age 60.7±15.4 years, 57.8% female) were identified. The indications included post-herpetic neuralgia (PHN) (30.5%), musculoskeletal diseases other than fibromyalgia (21.2%), fibromyalgia (18.4%), diabetic peripheral neuropathic pain (DPNP) (11.7%) and epilepsy (2.9%). Overall, 62.5% and 6.4% of patients achieved a maximum dose of ≥150 and ≥300 mg/day, respectively. The median duration of persistent pregabalin use was 28 days (interquartile range 14-118 days). The one-year persistence rate was 12.1%, and the indications associated with the highest and lowest persistence rates were epilepsy (42.4%) and PHN (6.1%), respectively. Male gender (odds ratio [OR] 1.14, 95% confidence interval [CI] 1.09-1.18), older age (OR 1.01 per year, 95% CI 1.01-1.01), indications other than PHN, especially epilepsy (OR 8.04, 95% CI 7.33-8.81, PHN as reference), and a higher initial dose (OR 1.12 per 75 mg, 95% CI=1.10-1.15) were associated with persistence at one year, whereas the initial concomitant use of antiviral agents decreased the likelihood (OR 0.41, 95% CI 0.35-0.47).Conclusions Pregabalin prescriptions for pain disorders were limited to short-term use, which is consistent around the world. However, the average prescribed dose in Taiwan was lower than those in Western countries, and was typically frequently below the recommended ranges. Potential causes included the duration of natural history of PHN, and off-label prescriptions for pain in acute herpes zoster, rather than PHN, as well as intolerance to the side effects.

show abstract

Recent prescription status of oral analgesics in Japan in real-world clinical settings: retrospective study using a large-scale prescription database

Cited by 26 publications

References 20 publications

Persistence of Pregabalin Treatment in Taiwan: a Nation-Wide Population-Based Study

Persistence of Pregabalin Treatment in Taiwan: a Nation-Wide Population-Based Study

Persistence of pregabalin treatment in Taiwan: a nation-wide population-based study

Persistence of Pregabalin Treatment in Taiwan: a Nation-Wide Population-Based Study

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