Evidence map›Paper›PMID 39934585›Full record

ArticleDrug safety2025

Risk of Fracture Associated with Pregabalin or Mirogabalin Use: A Case-Case-Time-Control Study Based on Japanese Health Insurance Claims Data.

Hinako Wakabayashi, Toshiki Fukasawa, Satomi Yoshida, Kairi Ri, Soichiro Masuda, Takayuki Anno, Koji Kawakami

Abstract read
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In one paragraph

Article in Drug safety, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Hinako WakabayashiDepartment of Pharmacoepidemiology, Graduate School of Medicine and Public Health, Kyoto University, Yoshidakonoe-cho, Sakyo-ku, Kyoto, 606-8501, Japan.ORCID http://orcid.org/0009-0000-1253-7890
Toshiki FukasawaDepartment of Pharmacoepidemiology, Graduate School of Medicine and Public Health, Kyoto University, Yoshidakonoe-cho, Sakyo-ku, Kyoto, 606-8501, Japan.ORCID http://orcid.org/0000-0001-7147-0737
Satomi YoshidaDepartment of Pharmacoepidemiology, Graduate School of Medicine and Public Health, Kyoto University, Yoshidakonoe-cho, Sakyo-ku, Kyoto, 606-8501, Japan.ORCID http://orcid.org/0000-0002-3411-9427
Kairi RiDepartment of Pharmacoepidemiology, Graduate School of Medicine and Public Health, Kyoto University, Yoshidakonoe-cho, Sakyo-ku, Kyoto, 606-8501, Japan.ORCID http://orcid.org/0000-0002-4039-576X
Soichiro MasudaDepartment of Pharmacoepidemiology, Graduate School of Medicine and Public Health, Kyoto University, Yoshidakonoe-cho, Sakyo-ku, Kyoto, 606-8501, Japan.ORCID http://orcid.org/0000-0003-4770-0728
Takayuki AnnoDepartment of Pharmacoepidemiology, Graduate School of Medicine and Public Health, Kyoto University, Yoshidakonoe-cho, Sakyo-ku, Kyoto, 606-8501, Japan.ORCID http://orcid.org/0009-0000-7490-5820
Koji KawakamiDepartment of Pharmacoepidemiology, Graduate School of Medicine and Public Health, Kyoto University, Yoshidakonoe-cho, Sakyo-ku, Kyoto, 606-8501, Japan. kawakami.koji.4e@kyoto-u.ac.jp.ORCID http://orcid.org/0000-0002-7477-4071

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPregabalin is widely used for neuropathic pain. Mirogabalin, a newer gabapentinoid, was recently introduced in several Asian countries. A previous case-crossover study showed an association between pregabalin and fall-related injuries, but the findings may have been affected by biases from individual- and population-level exposure time trends, and generalizability was limited due to a focus on a middle-aged population. Further, no findings have appeared on mirogabalin and its association with fall-related fractures.

objectiveWe conducted a case-case-time-control study to investigate the risk of fracture associated with pregabalin and mirogabalin in a population with broad demographic coverage.

methodsIncident fractures were identified from a Japanese claims database. For each case, hazard (days 1-30 before the fracture event) and control windows (days 61-90 before the event) were set. Each current case was matched by age and sex to a future case, defined as a patient who experienced a fracture 120-365 days later. Odds ratios (ORs) were estimated using conditional logistic regression models.

resultsA total of 814,216 and 460,811 cases were included in the pregabalin and mirogabalin analyses, respectively. ORs were 1.35 (95% confidence interval 1.28-1.43) for pregabalin and 1.53 (1.35-1.72) for mirogabalin, indicating an increased risk of fracture with both drugs. These results remained consistent and robust across sensitivity and subgroup analyses, except in patients under 65 years of age.

conclusionGiven this observed risk and the fact that these medications are commonly prescribed to older populations, caution is warranted in clinical use.

Indexed as

AnalgesicsFractures, BonePregabalinAdultAgedAged, 80 and overBridged Bicyclo CompoundsCase-Control StudiesDatabases, FactualEast Asian PeopleFemaleHumansInsurance, HealthJapanMaleMiddle AgedAnalgesicsBridged Bicyclo CompoundsmirogabalinPregabalin

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.