Evaluation of pregabalin-induced adverse events related to falls using the FDA adverse event reporting system and Japanese Adverse Drug Event Report databases

J Clin Pharm Ther. 2019 Apr;44(2):285-291. doi: 10.1111/jcpt.12790. Epub 2018 Dec 19.

Abstract

What is known and objective: Pregabalin is used for neuropathic and postherpetic pain and generalized anxiety. The aim of this study was to obtain the onset profiles of adverse events (AE) related to falls (AEFs) such as "somnolence," "dizziness," "loss of consciousness" and "fall" onset and several clinical factor combinations such as age and administered dose, using spontaneous reporting system (SRS) analysis such as the US Food and Drug Administration Adverse Event Reporting System (FAERS) database and the Japanese Adverse Drug Event Report (JADER) database.

Methods: We used the reporting odds ratio (ROR) to analyse the association between pregabalin and AEFs. Additionally, we used the time-to-onset analysis.

Results and discussion: The crude RORs of AEFs such as somnolence and dizziness were higher than one for both the databases. The adjusted RORs for AEFs in the ≥60 years age group compared to those in the <60 years age group for the FAERS and JADER databases were 1.46 (95% CI = 1.39-1.53; P < 0.0001) and 2.58 (95% CI = 2.06-3.27; P < 0.0001), respectively. In the JADER database, the median and quartile range for AEFs with pregabalin, at ≤75 and ≥100 mg/d, were 2.0 (0.0-5.0) and 2.0 (1.0-4.3) days, respectively. Additionally, 57.2% of AEFs (four preferred terms) were observed within 2 days after administration.

What is new and conclusions: This study is the first to evaluate the relationship between pregabalin and AEFs using the SRS analysis strategy. The risk of AEFs in the ≥60 years age group might increase compared to that in the <60 years age group. AEFs occurred almost within 1 week after pregabalin administration, and the median for AEF onset was 2 days. Our results show that patients should be closely monitored for AEFs for 1 week from the start of pregabalin administration.

Keywords: FAERS; JADER; adverse event; fall; pregabalin.

MeSH terms

  • Accidental Falls / statistics & numerical data*
  • Adverse Drug Reaction Reporting Systems / statistics & numerical data*
  • Age Distribution
  • Analgesics / adverse effects*
  • Databases, Factual
  • Dizziness / chemically induced
  • Dizziness / epidemiology
  • Humans
  • Japan
  • Middle Aged
  • Pregabalin / adverse effects*
  • Time Factors
  • United States
  • United States Food and Drug Administration

Substances

  • Analgesics
  • Pregabalin