Arthritis & Rheumatism, Volume 60,
October 2009 Abstract Supplement
The 2009 ACR/ARHP Annual Scientific Meeting
Philadelphia October 16-21, 2009.
Assessment of Pregabalin Utilization in Patients with Fibromyalgia at a University-Based Rheumatology Clinic
Lai1, William, Barnes1, Sean, Zhang1, Yingxue, Hackshaw1, Kevin V., Wolfe2, Thomas
To describe the utilization of Pregabalin in the management of FMS and whether the use of FMS approved medications improves patient care as assessed by changes in concomitant medications, opiate use, and fibromyalgia impact scores.
A retrospective cohort study of adult patients with a diagnosis of FMS on one or more encounters and treated with Pregabalin. Changes in concomitant medications over time were assessed from the Pregabalin Index Date to present or to the discontinuation of Pregabalin. Changes in concomitant medications were assessed for patients with more than 1 office visit (89).
A total of 185 patient records (89% female) were reviewed. Most patients had diagnosis of FMS for more than one year (78%). Pregabalin mean daily dose increased from baseline to follow-up, 82.3 ± 61.3 vs. 197 ± 141 (p<0.001), with 68% of patients experiencing a dose increase. A majority of patients were taking multiple medications (74%). Utilization of concomitant therapies increased from baseline to follow-up (0.94 ± 0.97 vs 1.64 ± 1.04, respectively, p<0.001). Current therapy in all patients consisted of 2.4 ± 1.2 (05) medications per patient. Concomitant medication changes occurred in 95 patients (51.4%). Of the patients currently on Pregabalin, fewer patients had discontinuation of concomitant medications vs. initiation of new medications (48 vs. 76, respectively). SNRI and muscle relaxants were the most common medications added. Concomitant opiate use was more common in patients on high dose (>= 300 mg/day) Pregabalin compared to low dose (47.8% vs. 21.2%, p=0.014). The number of concomitant medications was numerically higher in the high dose Pregabalin group (1.96 vs. 1.53, p=0.093). Patients initiated on Pregabalin at the Rheumatology clinic were more likely to be on low dose compared to patients on Pregabalin prior to clinic visit (72.9% vs. 41.7%, p=0.003). The number of concomitant medications (1.66 vs 1.92, p=0.267) and concomitant opiate use (27.1% vs 25%, p=0.833) was not different between those initiated on Pregabalin at the Rheumatology clinic compared to those on prior. Ninety-seven patients (83%) had documentation of symptom relief with Pregabalin. FIQ information was available in 85 patients (physical function score 1.29 ± 0.76 (03)). For patients with multiple FIQ scores, mean scores were not statistically different between time periods (68 ± 15.6 vs. 64.6 ± 10.6 p=0.198).
Concomitant medication use was common with increased utilization overall from baseline despite taking pregabalin. Discontinuation of concomitant medication is not common. The total number of concomitant medications was not significantly different regardless of where pregabalin was initiated. Relatively low doses of Pregabalin were used. Concomitant use of SNRI and muscle relaxants appeared to increase the most. Patients not on pregabalin when they visited Rheumatology clinic were likely to be on an opiate already.
To cite this abstract, please use the following information:
Lai, William, Barnes, Sean, Zhang, Yingxue, Hackshaw, Kevin V., Wolfe, Thomas; Assessment of Pregabalin Utilization in Patients with Fibromyalgia at a University-Based Rheumatology Clinic [abstract]. Arthritis Rheum 2009;60 Suppl 10 :1425