A recent analysis by experts in medication safety has determined that gabapentinoids, commonly prescribed for neuropathic pain, may heighten the risk of hip fractures—particularly among older, frail patients or those suffering from kidney problems.
The findings, published today in JAMA Network Open, monitored individuals in Victoria, Australia, who were hospitalized due to hip fractures between March 2013 and June 2018, focusing on those who had been using gabapentinoids prior to their injury.
Gabapentinoids have gained popularity as a perceived safer alternative to opioids for treating neuropathic pain, with their usage soaring eightfold from 2012 to 2018. During this timeframe, approximately one out of every seven Australians aged 80 and above received a prescription for gabapentinoids.
At present, gabapentinoids rank among the top ten medications subsidized by the Australian government based on volume.
Professor Simon Bell, co-author of the study and Director of the Centre for Medicine Use and Safety (CMUS) at the Monash Institute of Pharmaceutical Sciences, noted that while gabapentinoids can effectively alleviate neuropathic pain, they can also lead to unwanted side effects like dizziness, walking difficulties, and balance issues.
The researchers reviewed data from 28,293 patients who suffered hip fractures over the five-year study period.
“Our findings indicated a 30 percent increase in the likelihood of experiencing a hip fracture within two months of receiving a gabapentinoid prescription,” stated Professor Bell.
“The association between gabapentinoids and hip fractures was observed across various age demographics; however, the risk was significantly higher among individuals who were frail or had chronic kidney disease. This highlights the need for careful consideration when prescribing these medications.”
Despite these findings, Professor Bell emphasized the necessity for patients to consult their healthcare providers before choosing to stop taking their medications.
This study is the first to specifically indicate that frail patients receiving gabapentinoids have a higher risk of hip fractures compared to their non-frail counterparts.
Miriam Leung, the study’s lead author and a PhD candidate at CMUS, pointed out that the results underscore the need for caution in prescribing gabapentinoids, particularly to individuals at risk for falls and fractures.
“Our results stress the importance of evaluating each patient’s risk before prescribing gabapentinoids,” Leung added.
The team has called for additional research to explore the connection between hip fractures, varying doses of gabapentinoids, and different levels of kidney dysfunction.
Currently, researchers are collaborating with the University of Eastern Finland to examine hip fractures among patients living with Parkinson’s disease.
This research was a partnership between CMUS and teams from Austin Health and Harvard Medical School, with data funding provided by the Dementia Australia Research Foundation’s Yulgilbar Innovation Grant.
Professor Simon Bell, Director at CMUS and co-author of the study, is available for interviews.
