Interpreting the Effectiveness of Opioids and Pregabalin for Pain Severity, Pain Interference, and Fatigue in Fibromyalgia Patients.
Abstract: Objective: To evaluate the effectiveness of opioids and/or pregabalin on patient‐reported outcomes among fibromyalgia (FM) patients based on levels of improvement. Methods: A total of 1,421 FM patients were identified, with 3,082 observational periods of opioids with or without pregabalin...
| Publicado en: | Pain Practice Vol. 18; no. 5; pp. 611 - 625 |
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| Autores principales: | , , , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Wiley-Blackwell
Jun2018
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=129955926&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 129955926 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 15307085 HYN jtl: Pain Practice issn: 15307085 maglogo: Y pubinfo: dt: Jun2018 vid: 18 iid: 5 pid: 480 pub: Wiley-Blackwell place: Malden, Massachusetts artinfo: ui: 129955926 129955926 129955926 10.1111/papr.12651 129955926 ppf: 611 ppct: 14 formats: fmt: @attributes: type: P tig: atl: Interpreting the Effectiveness of Opioids and Pregabalin for Pain Severity, Pain Interference, and Fatigue in Fibromyalgia Patients. aug: au: Davis, Fred Gostine, Mark Roberts, Bradley A. Risko, Rebecca Cappelleri, Joseph C. Sadosky, Alesia affil: ProCare Systems, Inc., Grand Rapids, Michigan, U.S.A sug: subj: Narcotics Therapeutic Use Pregabalin Therapeutic Use Severity of Illness Fatigue Fibromyalgia Drug Therapy Patient-Reported Outcomes Human Morphine Administration and Dosage Pain Management ab: Abstract: Objective: To evaluate the effectiveness of opioids and/or pregabalin on patient‐reported outcomes among fibromyalgia (FM) patients based on levels of improvement. Methods: A total of 1,421 FM patients were identified, with 3,082 observational periods of opioids with or without pregabalin use between April 2008 and February 2015. Patients were categorized by opioids, and pregabalin with and without opioids; opioids were designated by morphine equivalent dose (MED) of ≤ 20 (low MED), > 20 to < 100 (moderate MED), ≥ 100 (high MED), and pregabalin doses of ≤ 150 mg, 151 to 300 mg, and 301 to 450 mg. Proportions of patients meeting clinically relevant thresholds of ≥ 30% and ≥ 50% improvement for pain interference (ability to enjoy life; activity; mood; relationships; sleep), pain severity, and fatigue were compared among treatments, and area under the curve (AUC) for improvement and worsening of effects was determined, enabling ranking of treatments. Further analysis compared pregabalin doses. Results: Pregabalin without opioids resulted in the highest proportions of patients with ≥ 30% improvement on all pain items and pain interference with “ability to enjoy life,” “activity” “mood,” and “sleep.” For the ≥ 50% threshold, pregabalin alone was highest for all pain interference items and for “average pain” and “worst pain.” Pregabalin was consistently lowest across thresholds for fatigue, but showed better results combined with moderate MED opioids. Pregabalin doses recommended for treatment of FM (151 to 450 mg) generally resulted in the highest proportion of patients achieving thresholds relative to opioids. The AUC results were consistent with thresholds; pregabalin without opioids resulted in the greatest benefits with regard to improvement, with the highest ranking for overall improvement and overall effects. Conclusion: Pregabalin without opioids provided the most favorable outcomes overall based on ≥ 30% and ≥ 50% improvement thresholds and AUC, with support for moderate MED opioids + pregabalin in patients suffering from fatigue. While most patients took less than recommended pregabalin doses, higher doses may lead to improved outcomes. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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