POS0265 ASSOCIATION OF PREGABALIN VS GABAPENTIN WITH INCIDENT CONGESTIVE HEART FAILURE IN PATIENTS WITH NON-CANCER PAIN

Background Chronic pain affects 30% of all patients in developed countries, accounting for up to 35% prescriptions acute care settings. Non-opioid medications are widely utilized treatment non-cancer chronic pain. Among these, pregabalin is a commonly prescribed anticonvulsant, which works by antagonizing L-type calcium channels, decreasing the release neurotransmitters [1] . Pregabalin use has been associated with reports congestive heart failure (CHF), including peripheral and pulmonary edema [2-4] However, relationship between CHF incidence among at highest risk adverse reactions (i.e., senior various co-morbidities) remains unclear. Objectives To compare incident new users versus gabapentin (the active comparator) Medicare beneficiaries treated Methods This was retrospective cohort study aged 65-89 years old pain, without prior history CHF. We included who were newly or followed 2015-2018. The outcome CHF, ascertained hospital admissions emergency room visits ICD 9 10 codes first position codes. Inverse probability weighting used account differences time-dependent analysis Cox proportional-hazards regressions). Covariates propensity scoring selected based on knowledge literature review, categories such as concurrent baseline cardiovascular, neurologic, psychiatric diagnoses corresponding opioids antipsychotics. Non-diagnostic covariates included, well demographics, socioeconomic status, indicators/metrics health utilization. Results 17,756 221,053 gabapentin. predominantly female gender (66.7%), non-Hispanic White (79.9%), median age 73 (IQR: 69-78) years. most common diagnostic indications musculoskeletal back Prior inverse weighting, vs had higher daily short-acting opioid morphine equivalent doses (median; 18.0 8.9 mg/d), coxibs (8.6% 4.9%), prevalence diabetic neuropathy (15.9% 11.3%) fibromyalgia (19.9% 13.2%). After score none standardized difference>0.10. During 110,439 person-years follow-up, 1,428 rate 18.67 per 1000 12.57 1000-person (adjusted HR 1.48 [95% CI, 1.20-1.81]). Conclusion In this rates hospitalizations compared References [1]Bockbrader HN, Wesche D, Miller R, Chapel S, Janiczek N, Burger P. A comparison pharmacokinetics pharmacodynamics Clin Pharmacokinet. 2010 Oct;49(10):661-9. [2]Murphy Mockler M, Ryder Ledwidge McDonald K. Decompensation neuropathic J Card Fail. 2007 Apr;13(3):227-9. [3]Page RL 2nd, Cantu Lindenfeld J, Hergott LJ, Lowes BD. Possible exacerbation pregabalin: case discussion review. Cardiovasc Med (Hagerstown). 2008 Sep;9(9):922-5. [4]Zaccara G, Gangemi P, Perucca Specchio L. event profile systematic review meta-analysis randomized controlled trials. Epilepsia. 2011 Apr;52(4):826-36 Acknowledgements: NIL. Disclosure Interests None Declared.