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Use of gabapentinoid medications among US adults with cancer, 2005–2015

  • Alex J. FauerEmail author
  • Matthew A. Davis
  • Sung Won Choi
  • Lauren P. Wallner
  • Christopher R. Friese
Commentary

Abstract

Background

Gabapentinoid use for long-term cancer pain control may be problematic, given unclear mechanisms of action and increased concerns for physical dependence. The purpose of this report is to examine trends of gabapentinoid use among US adults with cancer from 2005 to 2015.

Methods

We conducted a serial, cross-sectional study using data from the Medical Expenditure Panel Survey (MEPS). We performed multiple logistic regression to examine the annual percentages of gabapentinoid users, which were adjusted for age, sex, and US region of residence. The amount of gabapentinoid prescriptions filled in 2015 was also estimated.

Results

The adjusted percentage of gabapentinoid users in 2015 was 5.60% (3.79%, 7.41%), 2.39 times greater than the percentage in 2005 (p < .001). By 2015, the number of gabapentinoid prescriptions had grown to approximately 3.52 million (2.40 million, 4.65 million).

Conclusion

We observed greater than a twofold increase in the trend of gabapentinoid medication use among US adults with cancer. Investigations on the long-term efficacy of gabapentinoids for complex pain syndromes, and mitigation of risks, is essential to guide informed clinical management and keep patients safe.

Keywords

Cancer Supportive care Gabapentin Practice pattern 

Notes

Author contributions

Concept and design: Fauer, Davis, and Friese. Acquisition, analysis, or interpretation of data: all authors. Drafting of the manuscript: all authors. Critical revision of the manuscript for important intellectual content: all authors. Statistical analysis: Fauer and Davis. Administrative, technical, or material support: all authors. Supervision: all authors.

Funding information

Mr. Fauer is supported in part by a Doctoral Scholarship in Cancer Nursing (133507-DSCN-19-048-01-SCN) from the American Cancer Society; the Jonas Nurse Scholars Program; and the Hillman Scholars Program in Nursing Innovation. Research reported in this paper was supported by the National Cancer Institute of the National Institutes of Health under award number P30CA046592 (Friese).

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Supplementary material

520_2019_5100_MOESM1_ESM.docx (17 kb)
ESM 1 (DOCX 16 kb)

References

  1. 1.
    van den Beuken-van Everdingen M, de Rijke J, Kessels A, Schouten H, van Kleef M, Patijn J (2007) Prevalence of pain in patients with cancer: a systematic review of the past 40 years. Annals of Oncology 18(9):1437–1449.  https://doi.org/10.1093/annonc/mdm056 CrossRefGoogle Scholar
  2. 2.
    Goodman CW, Brett AS (2017) Gabapentin and pregabalin for pain — is increased prescribing a cause for concern? New England Journal of Medicine. 377(5):411–414.  https://doi.org/10.1056/NEJMp1704633 CrossRefPubMedGoogle Scholar
  3. 3.
    Portenoy RK, Lesage P (1999) Management of cancer pain. THE LANCET. 353:6CrossRefGoogle Scholar
  4. 4.
    National Cancer Institute. The opioid epidemic and cancer pain management. National Cancer Institute. https://www.cancer.gov/news-events/cancer-currents-blog/2018/opioid-crisis-cancer-pain-paice. Published July 16, 2018. Accessed June 5, 2019.
  5. 5.
    Goodman CW, Brett AS (2019) A clinical overview of off-label use of gabapentinoid drugs. JAMA Internal Medicine. 179(5):695.  https://doi.org/10.1001/jamainternmed.2019.0086 CrossRefPubMedGoogle Scholar
  6. 6.
    Shinde S, Gordon P, Sharma P, Gross J, Davis MP (2015) Use of non-opioid analgesics as adjuvants to opioid analgesia for cancer pain management in an inpatient palliative unit: does this improve pain control and reduce opioid requirements? Support Care Cancer. 23(3):695–703.  https://doi.org/10.1007/s00520-014-2415-9 CrossRefPubMedGoogle Scholar
  7. 7.
    Mersfelder TL, Nichols WH (2016) Gabapentin: abuse, dependence, and withdrawal. Annals of Pharmacotherapy. 50(3):229–233.  https://doi.org/10.1177/1060028015620800 CrossRefPubMedGoogle Scholar
  8. 8.
    Agency for Healthcare Research and Quality. Medical expenditure panel survey household component overview. Medical expenditure panel survey. https://meps.ahrq.gov/mepsweb/survey_comp/household.jsp. Published April 22, 2019. Accessed June 5, 2019.
  9. 9.
    Harrison JM, Lagisetty P, Sites BD, Guo C, Davis MA (2018) Trends in prescription pain medication use by race/ethnicity among US Adults with noncancer pain, 2000–2015. American Journal of Public Health. 108(6):788–790.  https://doi.org/10.2105/AJPH.2018.304349 CrossRefPubMedGoogle Scholar
  10. 10.
    Guy GP, Zhang K, Bohm MK et al (2017) Vital signs: changes in opioid prescribing in the United States, 2006–2015. MMWR Morb Mortal Wkly Rep 66(26):697–704.  https://doi.org/10.15585/mmwr.mm6626a4 CrossRefPubMedPubMedCentralGoogle Scholar
  11. 11.
    Yan PZ, Butler PM, Kurowski D, Perloff MD (2013) Beyond neuropathic pain: gabapentin use in cancer pain and perioperative pain. Clin J Pain 1. doi: https://doi.org/10.1097/AJP.0000000000000014
  12. 12.
    Song SJ, Min J, Suh SY et al (2017) Incidence of taxane-induced peripheral neuropathy receiving treatment and prescription patterns in patients with breast cancer. Support Care Cancer. 25(7):2241–2248.  https://doi.org/10.1007/s00520-017-3631-x CrossRefPubMedGoogle Scholar
  13. 13.
    Shah A, Hoffman EM, Mauermann ML et al (2018) Incidence and disease burden of chemotherapy-induced peripheral neuropathy in a population-based cohort. J Neurol Neurosurg Psychiatry 89(6):636–641.  https://doi.org/10.1136/jnnp-2017-317215 CrossRefPubMedPubMedCentralGoogle Scholar
  14. 14.
    Appleyard T, Ashworth J, Bedson J, Yu D, Peat G (2019) Trends in gabapentinoid prescribing in patients with osteoarthritis: a United Kingdom national cohort study in primary care. Osteoarthritis and Cartilage.  https://doi.org/10.1016/j.joca.2019.06.008 CrossRefGoogle Scholar
  15. 15.
    Johansen M (2018) Gabapentinoid use in the United States 2002 through 2015. JAMA Internal Medicine 178(2):292–294.  https://doi.org/10.1001/jamainternmed.2017.7856 CrossRefPubMedPubMedCentralGoogle Scholar
  16. 16.
    Deljou A, Hedrick SJ, Portner ER et al (2018) Pattern of perioperative gabapentinoid use and risk for postoperative naloxone administration. British Journal of Anaesthesia. 120(4):798–806.  https://doi.org/10.1016/j.bja.2017.11.113 CrossRefPubMedGoogle Scholar
  17. 17.
    Savelloni J, Gunter H, Lee K et al (2017) Risk of respiratory depression with opioids and concomitant gabapentinoids. JPR 10:2635–2641.  https://doi.org/10.2147/JPR.S144963 CrossRefGoogle Scholar
  18. 18.
    Gomes T, Juurlink DN, Antoniou T, Mamdani MM, Paterson JM, van den Brink W (2017) Gabapentin, opioids, and the risk of opioid-related death: A population-based nested case–control study. Tsai AC, ed. PLoS Med 14(10):e1002396.  https://doi.org/10.1371/journal.pmed.1002396 CrossRefPubMedPubMedCentralGoogle Scholar
  19. 19.
    Peckham AM, Fairman KA, Sclar DA (2018) All-cause and drug-related medical events associated with overuse of gabapentin and/or opioid medications: a retrospective cohort analysis of a commercially insured US population. Drug Saf. 41(2):213–228.  https://doi.org/10.1007/s40264-017-0595-1 CrossRefPubMedGoogle Scholar
  20. 20.
    Abou-Khalil B (2008) Levetiracetam in the treatment of epilepsy. Neuropsychiatric Disease and Treatment 507.  https://doi.org/10.2147/NDT.S2937

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.School of NursingUniversity of MichiganAnn ArborUSA
  2. 2.Center for Improving Patient and Population HealthUniversity of MichiganAnn ArborUSA
  3. 3.Rogel Cancer CenterUniversity of MichiganAnn ArborUSA
  4. 4.Medical SchoolUniversity of MichiganAnn ArborUSA
  5. 5.School of Public Health, Department of Health Management and PolicyUniversity of MichiganAnn ArborUSA

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