Clinical correlates and outcomes associated with pregabalin use among people prescribed opioids for chronic non-cancer pain: a five-year prospective cohort study
Nielsen, S and Gisev, N and Leung, J and Clare, P and Bruno, R and Lintzeris, N and Larance, B and Blyth, F and Hall, W and Cohen, M and Degenhardt, L and Farrell, M and Campbell, G, Clinical correlates and outcomes associated with pregabalin use among people prescribed opioids for chronic non-cancer pain: a five-year prospective cohort study, British Journal of Clinical Pharmacology pp. 1-13. ISSN 0306-5251 (2020) [Refereed Article]
Aims: Pregabalin has become widely used as an alternative to opioids in treating certain types of chronic non-cancer pain, but few studies have examined its clinical efficacy outside trials. We address this gap by examining the utilization, correlates and
clinical outcomes of pregabalin use among an Australian community-based cohort of
people prescribed opioids for chronic non-cancer pain.
Methods: Through a five-year prospective cohort study (n = 1514) we examined
associations between pregabalin use and pain severity and interference, mental
health, opioid dose and past month use of ambulance and emergency department
services. We used fixed-effects regression models to examine within-participant differences, and random-effects regression models to examine within- and between participant differences in clinical outcomes.
Results: In an analysis of cases with complete data over five-years (n = 896), the
prevalence of pregabalin use ranged from 16% at cohort entry to 29% at 36- and
48-months, and 46% reported pregabalin use at any time during the five years.
Pregabalin use was associated with greater pain severity and interference and greater
use of high-risk opioid doses (>90 oral morphine equivalents/day). Pregabalin use was not associated with changes in mental health symptoms, ambulance or
emergency department attendance in the fixed or random effects models.
Conclusions: Pregabalin use was common, but for most people use was not
associated with clinically meaningful improvements in pain or functioning.