A.Y.L.C., A.S.C.Y., D.H.T.T., W.C.Y.L., Y.H.J., Y.H., D.P.J.O., J.F.H., F.M.C.B., E.C.C.L., L.W., K.T., I.C.K.W. and K.K.C.M. critically revised the manuscript for important intellectual content. L.W., I.C.K.W. and K.K.C.M were responsible for database acquisition. The MIDAS data from IQVIA are available under restricted access for licensing reasons, access can be obtained by entering into additional licensing agreement with IQVIA. The raw MIDAS data were protected and are not publicly available due to data protection agreement with IQVIA. With additional data use agreement and permission from IQVIA, MIDAS data will be made available from the corresponding authors upon request.
COST-EFFECTIVENESS OF PREGABALIN COMPARED TO GABAPENTIN IN TREATMENT OF PATIENTS WITH POSTHERPETIC NEURALGIA
- Our sensitivity analysis using only retail data showed that the lack of hospital coverage only affected the estimates for individual countries and did not significantly affect the multinational or regional consumption levels.
- Patients who have a history of opioid, benzodiazepine, or alcohol misuse have been reported as being vulnerable to misuse of gabapentinoids12,16,24,40.
- Contributing factors that might account for the increasing consumption of pregabalin since the start of the study period include its twice-daily dosage regimen and more rapid absorption in contrast to gabapentin38,42.
It leads to improved outcomes including lower pain scores and more days with no or mild pain. Nine respondents reported having psychopathological symptoms prior to starting pregabalin use, four of whom had sought emergency and planned psychiatric care due to psychoactive substance use, and three had sought psychological help. This will allow for a deeper understanding of the problem and reveal hidden aspects that may be overlooked when using quantitative methods. Pregabalin meets all of these criteria, as it disinhibits the sexual sphere and increases libido 19, 54, increases sociability 53, has anti-anxiety 50 and psychostimulant effects pregabalin price usa 51, 52, and leads to delayed ejaculation and anorgasmia 177, 178, 179.
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After reviewing the titles and abstracts and excluding non-randomized studies, 806 studies were eliminated, resulting in 133 articles. After excluding studies that did not compare pregabalin with placebo, other drugs for the indication of GAD, or other types of reviews, 99 studies were eliminated, leaving 34 studies. After reviewing the full text, 20 studies were eliminated because of duplication or not being used for GAD, resulting in 14 studies. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach utilizing GRADEpro was employed to assess the certainty of the outcomes (Guyatt et al., 2013). GRADE evaluates the quality of evidence based on factors such as the study design, risk of bias, inconsistency, indirectness, imprecision, and publication bias.
Different from previous studies, which are limited to the national level or individual therapeutic agents9,11,23,24,25,26, the results include 65 countries and regions across the globe and include all gabapenitnoid agents that are available during the studied period. The results indicate an overall increase in gabapentinoid consumption from 2008–2018 across different countries. Pooled regional gabapentinoid consumption rates are highest in North America, followed by Oceania and Northern Europe in 2018. Lower-middle income countries have the largest growth in consumption.
These could be the only explanation for mentioned baseline differences, as groups were similar in distribution of type of neuropathic pain, elapsed time from diagnosis and the rest of demographic characteristics collected in the trial. It appeared that subjects receiving PGB as monotherapy could be less resistant patients. Other possible limitation is the unbalanced sample size of non-PGB group in comparison with the other two groups reflecting a possible selection preference of participants for pregabalin.
