Gabapentinoid Use, Potential Misuse, and Associated Risk Factors among U.S. Adult Cancer Survivors: A Retrospective Cohort Study
Author(s)
Jyun-Heng Lai, BPharm, MS1, Anton Avanceña, PhD1, Jamie Barner, PhD, FAACP, FAPhA1, Chanhyun Park, MEd, RPh, PhD1, Kirk Evoy, PharmD, BCACP, BC-ADM, CTTS, FCCP, FTSHP2, Jennifer Spencer, PhD3;
1The University of Texas at Austin, Health Outcomes Division, College of Pharmacy, Austin, TX, USA, 2The University of Texas at Austin, Pharmacotherapy and Translational Sciences Division, College of Pharmacy, Austin, TX, USA, 3The University of Texas at Austin, Department of Population Health, Dell Medical School, Austin, TX, USA
1The University of Texas at Austin, Health Outcomes Division, College of Pharmacy, Austin, TX, USA, 2The University of Texas at Austin, Pharmacotherapy and Translational Sciences Division, College of Pharmacy, Austin, TX, USA, 3The University of Texas at Austin, Department of Population Health, Dell Medical School, Austin, TX, USA
Presentation Documents
OBJECTIVES: Gabapentinoids, including gabapentin and pregabalin, are commonly prescribed to treat pain and other off-label conditions in cancer survivors. However, their utilization and potential for misuse in this population remain unclear. We aimed to assess gabapentinoid use, potential misuse, and associated risk factors among U.S. adult cancer survivors.
METHODS: We conducted a retrospective cohort study by analyzing Merative MarketScan claims data (2014-2022). Cancer survivors were eligible if they were ≥18 years old, had a malignant neoplasm diagnosis, and maintained continuous enrollment. We examined patterns of gabapentinoid use, misuse, and concomitant use with opioids, as well as use across cancer types and opioid dosages in morphine milligram equivalents (MME). We compared baseline characteristics of gabapentinoid users with an active comparator group-duloxetine users and identified determinants of misuse using multivariable logistic regressions.
RESULTS: Of 3,203,638 eligible cancer survivors, 224,045 (7%) and 40,182 (1.3%) used gabapentin and pregabalin, respectively. Gabapentin use increased from 3.1% in 2015 to 7% in 2021 (p<0.001), while pregabalin use remained stable around 1%. Misuse of any gabapentinoid was 2.6%-3.2%. Nearly half (47%-53%) of gabapentinoid users had previously received opioids. Gabapentinoid use was higher in five cancer types: female breast, lung/bronchus, colorectal, head/neck, and upper gastrointestinal cancers. Gabapentinoid misuse was significantly higher among individuals using opioid doses ≥50 MME versus those using gabapentinoids alone (gabapentin 5.2% vs. 2.8%; p<0.001). Both gabapentinoid groups showed higher use of antineoplastic agents, cancer surgeries, and oncology specialty visits, and had more physical comorbidities than the duloxetine group. Multivariable analysis revealed that geographic region, non-metropolitan statistical area, Medicare coverage, oncology specialty visits, opioid use ≥50 MME, and specific neurological and mental disorders were associated with increased odds of gabapentinoid misuse.
CONCLUSIONS: This study described gabapentinoid use and potential misuse among U.S. adult cancer survivors and identified risk factors like high opioid doses that may contribute to gabapentinoid misuse.
METHODS: We conducted a retrospective cohort study by analyzing Merative MarketScan claims data (2014-2022). Cancer survivors were eligible if they were ≥18 years old, had a malignant neoplasm diagnosis, and maintained continuous enrollment. We examined patterns of gabapentinoid use, misuse, and concomitant use with opioids, as well as use across cancer types and opioid dosages in morphine milligram equivalents (MME). We compared baseline characteristics of gabapentinoid users with an active comparator group-duloxetine users and identified determinants of misuse using multivariable logistic regressions.
RESULTS: Of 3,203,638 eligible cancer survivors, 224,045 (7%) and 40,182 (1.3%) used gabapentin and pregabalin, respectively. Gabapentin use increased from 3.1% in 2015 to 7% in 2021 (p<0.001), while pregabalin use remained stable around 1%. Misuse of any gabapentinoid was 2.6%-3.2%. Nearly half (47%-53%) of gabapentinoid users had previously received opioids. Gabapentinoid use was higher in five cancer types: female breast, lung/bronchus, colorectal, head/neck, and upper gastrointestinal cancers. Gabapentinoid misuse was significantly higher among individuals using opioid doses ≥50 MME versus those using gabapentinoids alone (gabapentin 5.2% vs. 2.8%; p<0.001). Both gabapentinoid groups showed higher use of antineoplastic agents, cancer surgeries, and oncology specialty visits, and had more physical comorbidities than the duloxetine group. Multivariable analysis revealed that geographic region, non-metropolitan statistical area, Medicare coverage, oncology specialty visits, opioid use ≥50 MME, and specific neurological and mental disorders were associated with increased odds of gabapentinoid misuse.
CONCLUSIONS: This study described gabapentinoid use and potential misuse among U.S. adult cancer survivors and identified risk factors like high opioid doses that may contribute to gabapentinoid misuse.
Conference/Value in Health Info
2025-05, ISPOR 2025, Montréal, Quebec, CA
Value in Health, Volume 28, Issue S1
Code
EPH171
Topic
Epidemiology & Public Health
Topic Subcategory
Safety & Pharmacoepidemiology
Disease
SDC: Mental Health (including addition), SDC: Neurological Disorders, SDC: Oncology