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Nouvelle publication SUAL: évolution des dispensations de gabapentinoïdes dans les PASS lyonnaises

Nouvelle publication SUAL dans la revue Fundamental & Clinical Pharmacology. Il s'agit d'une étude de l'évolution des dispensations de gabapentinoïdes dans les Permanences d'Accès aux Soins de Santé (PASS) lyonnaises montre une augmentation brute de plus de 1000% des dispensations de prégabaline et gabapentine entre 2016 et 2021. Rapportées à l'évolution des files actives, ces augmentations restent au dessus d'un facteur 8. Ces chiffres précédaient les restrictions sur la prescription de prégabaline mises en place par l'ANSM en mars 2021.


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Gabapentinoid use in French most precarious populations: insight from Lyon Permanent Access to Healthcare (PASS) units, 2016 – 1Q2021


Mathieu Chappuy 1, 2, 3 *, Mikail Nourredine 4, 5, 6, Bertrand Clerc 7, Morgan Fahmi 8, Pauline Misslin 9, Maude Berthier 10, Louise Laloi 11, Benjamin Rolland 1, 2, 4, 12

1. Service Universitaire d’Addictologie de Lyon (SUAL), CH Le Vinatier, 69500 Bron, France
2. Service Universitaire d’Addictologie de Lyon (SUAL), GH Centre, Hospices Civils de Lyon, Lyon, France
3. CSAPA, GH Nord, Hospices Civils de Lyon, Lyon, France
4. Service hospitalo-universitaire de pharmacotoxicologie de Lyon, Hospices Civils de Lyon, Lyon, France
5. Service de recherche et épidémiologie clinique, Hospices Civils de Lyon, Lyon, France
6. Laboratoire d’évaluation et modélisation des effets thérapeutiques, UMR CNRS 5558, Lyon
7. Service Pharmaceutique, CH Le Vinatier, 69500 Bron, France
8. Service Permanence d’Accès aux Soins de Santé, CH Le Vinatier, 69500 Bron, France
9. Service Pharmaceutique, CH Saint Joseph – Saint Luc, 69007 Lyon, France
10. Service Permanence d’Accès aux Soins de Santé, GH Centre, Hospices Civils de Lyon, Lyon, France
11. Service Pharmaceutique, GH Centre, Hospices Civils de Lyon, Lyon, France
12. INSERM U1028, CNRS UMR 5292, CRNL, Université de Lyon, UCBL1, Bron, France

* Correspondence : Dr. Mathieu Chappuy, Service Universitaire d’Addictologie, CH Le Vinatier, Pôle MOPHA, 95 30Bd Pinel, 69500, Bron, France ; Tel +33 437 915 555

ABSTRACT

Background: Gabapentinoids (i.e., gabapentin and pregabalin) are medications approved for epilepsy, chronic pain, or generalized anxiety disorder. Recently, there have been regular reports of misuse of pregabalin, and to a lesser extent, gabapentin, in particular among opioid and polydrug users.

Objectives: To longitudinally explore the amounts of gabapentinoids dispensed in Lyon’s Permanent Access to Healthcare (PASS) units, which offer permanent and free healthcare to precarious populations with no healthcare insurance coverage.

Methods: We collected the amounts of pregabalin and gabapentin dispensed in the three PASS units of Lyon, and calculated the average doses dispensed monthly between 2016 and the first quarter of 2021 (1Q2021), with and without adjustment for the number of dispensing visits.

Results: The total doses of gabapentinoid dispensed every month in Lyon’s PASS units displayed a 1,233%-increase for pregabalin, and a 1,185%-increase for gabapentin, between 2016 and 1Q2021. When adjusted for the number of visits, this increase reached a factor of 8.5 for pregabalin, and 8.3 for gabapentin, respectively. However, while the increase in pregabalin dispensing was constant throughout the study period, gabapentin total dispensed doses were more fluctuating over time, and the rise of dispensations was thus less straightforward.

Conclusion: Our study reveals a local but substantial increase in gabapentinoid use in populations with no social insurance. These findings should be confirmed more widely, and plead for the systematic collection of anonymous patient data in free healthcare centers in France.