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Our study suggests a modest association between current gabapentinoid use and fractures in patients with IA, after accounting for measured and time-invariant unmeasured confounding. Whilst other unmeasured confounding remains possible, given the absence of evidence for gabapentinoid efficacy in pati Treatment with gabapentinoids in patients with inflammatory arthritis (IA) appears to increase the risk of fractures, according to findings of a UK study published in BMC Medicine. No benefit, though, was seen with scheduled postoperative gabapentin in patients undergoing total knee arthroplasty, total hip arthroplasty, thoracotomy, and shoulder arthroscopy [8-11] Studies of gabapentin use specifically in trauma patients have been limited to rib fractures, blunt thoracic trauma, spinal cord injury, and amputations. Similar to previous studies linking antidepressant and benzodiazepine use to hip fractures, the research showed that gabapentinoid use was also associated with in elevated risk of hip fractures among older adults, especially in those identified as frail or with chronic kidney disease. Gabapentin (Neurontin) can also be utilized in the multimodal treatment of rib fractures, but there is no consensus on its proven benefit. A recent randomized control trial of gabapentin vs. placebo in critically ill patients with rib fractures showed no benefit to gabapentin use with similar hospital and ICU length of stay, incentive Researchers found a 30 percent higher risk of hip fractures in the patients taking gabapentin during the two months before their fracture. They also found an even higher risk for patients taking gabapentin who were diagnosed as frail or who had kidney disease. Melbourne, Australia —Gabapentinoids should be used with caution among patients at risk of hip fractures, especially those who are frail, according to a new study. That is especially concerning, according to the researchers from Monash University in Australia and colleagues, because the increased use of gabapentinoids has been most pronounced in older people who are also susceptible to hip In this population-based case-case-time-control study of Australian adults hospitalized for first hip fracture, the use of gabapentinoids was associated with a higher risk of hip fractures, especially in patients who were frailer or with chronic kidney disease. Observational studies in non-IA populations suggest gabapentinoids are associated with fractures but are limited by methodological heterogeneity and potential residual confounding. Patients with IA generally have an increased risk of fracture so may be particularly vulnerable. Background Gabapentinoids are increasingly prescribed in inflammatory arthritis (IA), despite no trial evidence for efficacy at managing pain in this population. Observational studies in non-IA populations suggest gabapentinoids are associated with fractures but are limited by methodological heterogeneity/potential residual confounding. Patients with IA generally have an increased risk of Although gabapentin has shown promise following elective thoracic procedures, its efficacy in patients with rib fractures remains unstudied. We hypothesized that gabapentin, as compared to placebo, would both improve acute pain control and decrease narcotic use among critically ill patients with rib fractures. Study results showed patients had a 30 percent greater risk of suffering a hip fracture within two months of being given a gabapentinoid medication. The link between gabapentinoids and hip fractures existed across different age groups, but the odds of hip fracture were higher among patients who were frailer or had chronic kidney disease. In this case-case-time-control study of Australian residents hospitalized for hip fracture, gabapentinoid use was associated with an increased risk of hip fractures, especially in patients who were frail or had chronic kidney disease. This study is the first to evaluate the effects of long-term pregabalin and gabapentin use on fracture healing by assessing histological, radiological, and biomechanical outcomes, comparing these agents both with each other and a control group. Achieving adequate pain control for rib fractures remains challenging; prescription of alternatives to narcotics is imperative to curtail the current opioid epidemic. Although gabapentin has shown promise following elective thoracic procedures, its efficacy in patients with rib fractures remains unstudied. We hypothesized that gabapentin, as compared to placebo, would both improve acute pain The high prevalence of pregabalin prescribing in this study reflects prescribing patterns in Australia, where pregabalin is much more commonly used than gabapentin. However, given their similar side effect profiles, we can assume reasonably that gabapentin also is associated with hip fracture risk. Rib fractures (RF) are common injuries. Multiple analgesia strategies are available for treatment of pain associated with RF. However, the optimal mul Examining associations by gabapentinoid type revealed stronger increased risks of fragility fractures with recent gabapentin use in all models (fully adjusted OR 1.79 [1.21, 2.64]) than for recent pregabalin use (fully adjusted OR 1.33 [0.82, 2.14]). Current any gabapentinoid use (vs. remote use) associated with a significantly increased fracture risk (OR 1.35 [95% CI 1.22, 1.50]). Similar risks were seen with gabapentin (OR 1.31 [1.13, 1.52]) and pregabalin (OR 1.44 [1.22, 1.70]). 2. Pain and disability associated with vertebral fragility fractures Patients with low trauma vertebral fractures will need advice on pharmacological options to help with pain control. There are few good quality trials of pain medication and effectiveness in management of vertebral fragility fractures.
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