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Fractures among older patients receiving mirogabalin versus pregabalin: A retrospective cohort study using a large claims database in Japan
  • Kanako Makito,
  • Akira Okada,
  • Hideo Yasunaga
Kanako Makito
Tokyo Daigaku

Corresponding Author:[email protected]

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Akira Okada
Tokyo Daigaku Tokyo College
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Hideo Yasunaga
Tokyo Daigaku Daigakuin Igakukei Kenkyuka Igakubu Kokyo Kenko Igaku Senko Rinsho Ekigaku Keizaigaku
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Abstract

Purpose: Mirogabalin has a mechanism similar to that of pregabalin in the treatment of neuropathic pain. However, it remains unclear whether these drugs differ in terms of serious side effects, such as fall-related fractures, in older patients. This study aimed to investigate whether mirogabalin is associated with a decrease in fractures compared with pregabalin. Methods: We performed a retrospective cohort study using the DeSC database, a large administrative claims database in Japan. This study involved 49,393 patients ≥ 65 years taking mirogabalin or pregabalin between April 2019 and March 2020.The cumulative incidence of fractures was compared between those receiving mirogabalin and those receiving pregabalin using Kaplan-Meier curves and multivariable Cox proportional hazards models. A sensitivity analysis was performed for patients who received mirogabalin or pregabalin without other analgesic medications at the initial dose. Results: During a median follow-up of 20 months, 8,152 (16.5%) and 41,241(83.5%) received pregabalin, respectively. The proportions of fractures in the mirogabalin and pregabalin groups were 24.2% and 25.5%, respectively. Cox regression analysis showed that mirogabalin was associated with a lower risk of fractures (hazard ratio, 0.88; 95% confidence interval, 0.84–0.93). Sensitivity analysis also demonstrated a significant difference in fracture events between the mirogabalin and pregabalin groups without other analgesic medications (hazard ratio, 0.88; 95% confidence interval, 0.82–0.96). Conclusions: Our analyses suggest that the administration of MGB was associated with a decreased probability of fracture compared with PGB, although further studies are warranted to confirm these findings.
27 Mar 2024Submitted to Pharmacoepidemiology and Drug Safety
27 Mar 2024Assigned to Editor
27 Mar 2024Submission Checks Completed
27 Mar 2024Review(s) Completed, Editorial Evaluation Pending
01 Apr 2024Reviewer(s) Assigned