The use of pregabalin alone vs pregabalin plus opioids or opioids alone may result in more favorable outcomes in terms of pain interference and pain severity in patients with fibromyalgia, according to an observational analysis published in Pain Practice.

Researchers compared pain outcomes in 1421 patients with fibromyalgia taking opioids or pregabalin with or without opioids. A total of 3082 pre- and post-observational periods were included in the final analysis. The pregabalin dosages were higher in study participants taking the drug in combination with opioids vs pregabalin alone.

Improvements ≥30% in pain interference with activity, mood, sleep, and “ability to enjoy life,” and all measures of pain (including average pain, worst pain, and “pain right now”) were most prevalent in patients taking pregabalin without opioids.

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The improvement in all pain measures associated with pregabalin alone vs pregabalin plus opioid treatment was found to be significant for “pain right now while completing your pain health assessment” (13.2%, CI 0.8%, 27.2%, respectively; P <.05), and patients achieving a ≥30% improvement in “relationships with others” were more likely to be taking pregabalin without than with opioids.

According to the investigators, the 301 mg to 450 mg range of pregabalin dosages in this study “generally provided the most benefit to patients compared with other pregabalin dosages as well as with patients prescribed only opioids.”

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Davis F, Gostine M, Roberts BA, et al. Interpreting the effectiveness of opioids and pregabalin for pain severity, pain interference, and fatigue in fibromyalgia patients. Pain Pract [published online October 24, 2017]. doi:10.1111/papr.12651