Suhl Jonathan, Conway Kristin M, Thomas Shiny, Rasmussen Sonja A, Howard James F, Johnson Nicholas E, Romitti Paul A, Mathews Katherine D
Department of Epidemiology, College of Public Health, The University of Iowa, Iowa City, Iowa, USA.
New York State Department of Health, Albany, New York, USA.
Muscle Nerve. 2025 Sep;72(3):475-484. doi: 10.1002/mus.28460. Epub 2025 Jun 23.
INTRODUCTION/AIMS: Pain is a recognized symptom of muscular dystrophy (MD), but little is known about prescription pain medications in this population. We describe pain experiences and pain medications prescribed for individuals with selected MDs using population-based surveillance data collected by the Muscular Dystrophy Surveillance, Tracking, and Research Network.
Pain and prescription data were abstracted from medical records for 1282 individuals with Duchenne and Becker (DBMD) MD during 2000-2015 and congenital (CMD), distal (DD), Emery-Dreifuss (EDMD), facioscapulohumeral (FSHD), limb-girdle (LGMD), and myotonic (DM) MDs during 2008-2016. Percentages of individuals prescribed pain medications for ≥ 6 weeks during follow-up were estimated. Logistic regression was used to examine associations with selected demographic and clinical characteristics.
Moderate pain was observed among 34% of all people with available pain scores and varied by MD type (13%-53%). Pain medications were prescribed for 31.1%-40.2% of people 20 years and older, but less frequently (< 15%) among people less than 20 years old. Among people prescribed pain medications, the first medication was typically a non-opioid (57%), but both non-opioid and opioid medication classes were prescribed during follow-up (34%). Pain medications were typically prescribed for longer than 1 year (> 85%). Impaired mobility had the strongest association with prescription pain medication.
The prescription of pain medication is common for people with symptomatic MD. Most people were prescribed only non-opioids. These data highlight pain management as a frequent component of MD care. Understanding modifiable factors associated with MD-related pain and effective interventions may help improve care.
引言/目的:疼痛是公认的肌肉萎缩症(MD)症状,但对于该人群中处方止痛药物的了解甚少。我们使用肌肉萎缩症监测、追踪和研究网络收集的基于人群的监测数据,描述了患有特定MD的个体的疼痛经历和所开具的止痛药物。
从2000 - 2015年期间1282例杜氏和贝克(DBMD)型MD患者以及2008 - 2016年期间先天性(CMD)、远端(DD)、埃默里 - 德赖富斯(EDMD)、面肩肱型(FSHD)、肢带型(LGMD)和强直性(DM)型MD患者的医疗记录中提取疼痛和处方数据。估计随访期间服用止痛药物≥6周的个体百分比。使用逻辑回归分析与选定的人口统计学和临床特征之间的关联。
在所有有可用疼痛评分的人群中,34%观察到中度疼痛,且因MD类型而异(13% - 53%)。20岁及以上人群中31.1% - 40.2%开具了止痛药物,但20岁以下人群中开具频率较低(<15%)。在开具止痛药物的人群中,首剂药物通常为非阿片类药物(57%),但随访期间非阿片类和阿片类药物类别均有开具(34%)。止痛药物通常开具超过1年(>85%)。行动能力受损与处方止痛药物的关联最强。
有症状的MD患者中开具止痛药物很常见。大多数人仅开具了非阿片类药物。这些数据凸显了疼痛管理是MD护理的常见组成部分。了解与MD相关疼痛相关的可改变因素和有效干预措施可能有助于改善护理。