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Abstract

A COMPARATIVE STUDY ON THE EVALUATION OF PREGABALIN VERSUS DULOXETINE AND THE PRESCRIBING TRENDS IN PATIENTS WITH FIBROMYALGIA SYNDROME

Dr. Mathew George*, Dr. Lincy Joseph, Ancia Manuel, Asha K. Chacko, Blessy Rachal Boban and Manjusha Joy

ABSTRACT

Objective: To determine and compare the safety, effectiveness and tolerability of Pregabalin and Duloxetine, to assess the quality of life among patients under this study along with assessing the medication adherence of drugs under study and to analyse the prescribing pattern of drugs in patients with fibromyalgia syndrome. Methods: A prospective, observational study was conducted. Patients who have been recently diagnosed and treated with pregabalin or duloxetine monotherapy were identified. The patients were then reviewed after 4 weeks to assess the effectiveness of the drugs under study using the Short Form McGill Pain Questionnaire (SF –MPQ). The tolerability was assessed and recorded at clinical visit by asking the patient about whether they had discontinued the drug or not by using Global Assessment Scale of Tolerability. The safety was assessed using Standard Adverse Reaction Questionnaire. The Fibromyalgia Impact Questionnaire (FIQ) was used to assess quality of life in fibromyalgia patients receiving monotherapy of pregabalin or duloxetine. The adherence was examined using 8-scale Morisky Medication Adherence Scale (MMAS). The prescription pattern of drugs used in fibromyalgia was also analysed. Results: Since the P value is less than 0.01, the difference in mean scores of effect, before and after are statistically highly significant in both the groups. Since the P value is less than 0.01, the difference in mean scores of quality of life before and after are statistically highly significant in both the groups. Since P value obtained is more than 0.05, there is no significant difference in safety among the groups. Since P value is less than 0.01, there is a highly significant association between tolerability and the groups. Among 35 patients on Pregabalin, monotherapy of Pregabalin (0-0-1) OD was mostly prescribed (38.71%). Among another 35 patients on duloxetine, 42.86% patients were on monotherapy of Duloxetine (0-0-1) OD. Most people were low and medium adherent to medications. Conclusions: Pregabalin was found to be more effective in reducing the pain compared to Duloxetine therapy. Constipation was the most common ADR observed in Duloxetine therapy. Thus, it can be concluded that Pregabalin therapy is more safer compared to Duloxetine therapy. Pregabalin was well tolerated compared to that of Duloxetine. It is observed that most of the patients on mixed diet had experienced Fibromyalgia. Thus it can be concluded that mixed diet and weight gain is associated with development of Fibromyalgia. The post menopausal were more prone to Fibromyalgia due to estrogen imbalance. Eventhough, PGN is found to be more effective than Duloxetine, cost is higher with pregabalin. So, cost reversal must be done for better therapy.

Keywords: Pregabalin, Duloxetine, Safety, Effectiveness,Tolerability, Quality of life.


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