Département universitaire de médecine générale, Faculté de Médecine, Université de Toulouse, France.
Unité Mixte de Recherche, 1027 Inserm-Université, Pharmacoépidémiologie, Université de Toulouse, France.
Br J Clin Pharmacol. 2019 Jun;85(6):1260-1269. doi: 10.1111/bcp.13892. Epub 2019 Mar 28.
The aim of this study was to assess the use and factors associated with the misuse of gabapentin and pregabalin in the general French population, through a cohort study in the EGB (General Sample of Beneficiaries), a national representative sample of the French general population.
New users of gabapentin and pregabalin were identified from June 2006 to December 2014, and new users of duloxetine served as control group. Misuse was defined as a use of higher daily doses than recommended. Cox proportional hazard regression models were performed to identify associated factors of misuse.
Misuse was more frequent in the 8692 new users of pregabalin (12.8%) than in the 1963 gabapentin (6.6%) or the 3214 duloxetine new users (9.7%) (P < 0.001). Factors associated with misuse were pregabalin (hazard ratio [HR] 1.48; 95% confidence interval [CI] [1.29-1.69]), age (HR 1.98 [1.70-2.31] and HR 1.25 [1.06-1.47]), multiple prescribers (HR 1.29 [1.15-1.45]; HR 1.54 [1.30-1.83]), cancer (1.28 [1.11-1.47]), multiple sclerosis (1.53 [1.07-2.18]), neuropathy (1.85 [1.19-2.89]), depression (1.26 [1.07-1.49]) and methadone (2.61 [1.16-5.84]). After this first episode of drug misuse, 11.6% of gabapentin and 10.7% of pregabalin misusers developed a primary addiction.
In a cohort of new users, misuse is more likely to occur in new users of pregabalin, with different associated factors of misuse compared to gabapentin and duloxetine. Health professionals and prescribers must be aware of this misuse potential, which could lead to abuse and dependence.
本研究旨在通过对 EGB（一般受益人群）的队列研究，评估加巴喷丁和普瑞巴林在法国普通人群中的使用情况和与滥用相关的因素，EGB 是法国普通人群的全国代表性样本。
从 2006 年 6 月至 2014 年 12 月，确定加巴喷丁和普瑞巴林的新使用者，并以度洛西汀的新使用者为对照组。滥用定义为使用的日剂量高于推荐剂量。采用 Cox 比例风险回归模型确定滥用的相关因素。
在 8692 名新使用普瑞巴林的患者中（12.8%），滥用的发生率高于 1963 名新使用加巴喷丁的患者（6.6%）或 3214 名新使用度洛西汀的患者（9.7%）（P<0.001）。与滥用相关的因素包括普瑞巴林（风险比[HR]1.48；95%置信区间[CI] [1.29-1.69]）、年龄（HR 1.98 [1.70-2.31] 和 HR 1.25 [1.06-1.47]）、多名处方医生（HR 1.29 [1.15-1.45]；HR 1.54 [1.30-1.83]）、癌症（1.28 [1.11-1.47]）、多发性硬化症（1.53 [1.07-2.18]）、神经病（1.85 [1.19-2.89]）、抑郁症（1.26 [1.07-1.49]）和美沙酮（2.61 [1.16-5.84]）。在首次药物滥用发作后，11.6%的加巴喷丁和 10.7%的普瑞巴林滥用者出现原发性成瘾。
在新使用者队列中，与加巴喷丁和度洛西汀相比，普瑞巴林新使用者更有可能出现药物滥用，且存在不同的滥用相关因素。卫生专业人员和处方医生必须意识到这种滥用的可能性，这可能导致滥用和依赖。
