Initiation of Pregabalin vs Gabapentin and Development of Heart Failure
Overview
Paper Summary
This retrospective cohort study of Medicare beneficiaries found that new users of pregabalin had an increased risk of heart failure compared to new users of gabapentin. The risk was particularly elevated in those with a history of cardiovascular disease. The study used a large dataset and controlled for over 200 potential confounding factors.
Explain Like I'm Five
For seniors with chronic pain, starting pregabalin might come with a slightly higher risk of heart problems compared to gabapentin, especially if they already have heart issues.
Possible Conflicts of Interest
Dr. Corriere reported receiving personal fees from Vertex Pharmaceuticals, and Dr. Chung reported receiving grants from the University of Miami and the NIH, all outside of the submitted work.
Identified Limitations
Rating Explanation
This study used a robust methodology including a large sample size, extensive covariate adjustment, and target trial emulation to minimize bias, strengthening the evidence for an association between pregabalin and heart failure risk in older adults. However, limitations regarding generalizability and potential unmeasured confounding warrant a slightly lower rating than 5.
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