Pregabalin use does not improve pain, functioning in opioid-prescribed patients

Use of pregabalin is prevalent among people prescribed opioids for chronic noncancer pain, but it appears to provide no clinically meaningful improvements in pain or functioning, a study has found.

“Pregabalin has become widely used as an alternative to opioids in treating certain types of chronic noncancer pain, but few studies have examined its clinical efficacy outside trials,” the authors said. “We address this gap by examining the utilization, correlates, and clinical outcomes of pregabalin use [in] an Australian community-based cohort of people prescribed opioids for chronic noncancer pain.”

A 5-year prospective cohort study of 1,514 individuals was conducted to examine the relationships of pregabalin use with pain severity and interference, mental health, opioid dose, and past month use of ambulance and emergency department services.

The authors fitted fixed-effects regression models to analyse within-participant differences and random-effects regression models to assess within- and between-participant differences in clinical outcomes.

Of the participants, 896 had complete data over 5 years. Analysis revealed that use of pregabalin ranged from 16 percent at cohort entry to 29 percent and 36- and 48-months. Additionally, 46 percent reported using pregabalin at any time during the study period.

Pregabalin use resulted in greater pain severity and interference, as well as greater use of high-risk opioid doses (>90 oral morphine equivalents/day). On the other hand, use of pregabalin did not lead to changes in mental health symptoms, ambulance or emergency department attendance in the fixed or random effects models.