Characteristics, resource utilization and safety profile of patients prescribed with neuropathic pain treatments: a real-world evidence study on general practices in Europe – the role of the lidocaine 5% medicated plaster

Abstract

Objectives: To identify characteristics, resource utilization, and safety profile of patients prescribed with lidocaine 5% medicated plaster, pregabalin, gabapentin, amitriptyline and duloxetine when experiencing pain in the real-world setting of general practitioners (GPs) in Europe.

Methods: Retrospective analysis on real world data from IMS Health Longitudinal Patient Database. Patients with at least one prescription of the drugs of interest during 2014 were selected and those with a non-neuropathic pain-related diagnosis were excluded. Patients’ demographic and clinical characteristics, resource utilization data and adverse drug reactions (ADRs) as described in the leaflet were extracted. The association between treatments and ADR occurrence was evaluated applying multivariate logistic models.

Results: A total of 70,515 patients were selected from Italy, Germany, the UK, Spain and Belgium. Lidocaine 5% medicated plaster patients were the oldest in Italy, the UK and Spain and the most health impaired in Italy, Spain and Belgium. No relevant differences in the number of co-prescriptions, specialist visits, examinations and hospitalizations were found. Significantly less lidocaine 5% plasters patients experienced ADRs, with odds ratios in favor of lidocaine 5% medicated plasters ranging from 3.41 (p = .036) to 52.33 (p < .001).

Conclusions: Evidence from daily clinical practice in GP settings agrees with the findings from more controlled clinical-trial settings, with lidocaine 5% medicated plaster patients showing a better safety profile, but also a comparable level of resource utilization. A possible re-evaluation of the scientific value coming from this retrospective study in building up a diagnostic as well as a therapeutic algorithm is suggested.

Keywords:

• Neuropathic pain
• general practitioners
• resources utilization
• safety

Transparency

Declaration of funding

This study was funded by Grunenthal GmbH.

Declaration of financial/other relationships

P.K. has disclosed that he was an employee of Grunenthal Gmbh at the time this study was conducted. V.P. has disclosed that she is an employee of QuintilesIMS. H.L. has disclosed that she is an employee of Grunenthal Gmbh.

CMRO peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Acknowledgements

All named authors take responsibility for the integrity of the work and have given final approval for the version to be submitted.