Pain Associated With Fibromyalgia
Conditions
Keywords
Lyrica, pregabalin, Good post marketing practice, Post Marketing Surveillance, Regulatory Post Marketing Commitment Plan, Fibromyalgia
Brief summary
To collect the efficacy and safety information of Pregabalin on Fibromyalgia patients related to their appropriate use in daily practice.
Detailed description
All the patients whom an investigator prescribes the first pregabalin should be registered consecutively until the number of subjects reaches target number in order to extract patients enrolled into the investigation at random.
Interventions
The usual adult dosage for oral use begins at 150 mg/day of pregabalin twice daily, and should be gradually increased to 300 mg/day over 1 week or more and then maintained at 300-450 mg/day as needed. Dosage should be adjusted, depending on age or symptoms. However, the daily maximum dose should not be beyond 450 mg, and should be orally administered twice daily.
Sponsors
Study design
Eligibility
Inclusion criteria
* Clinical diagnosis of Fibromyalgia * Pregabalin naive patient
Exclusion criteria
* Clinical diagnosis of neuropathic pain
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Percentage of Participants With Adverse Drug Reaction | From Week 1 to 52 weeks at maximum | An adverse drug reaction (ADR) was any untoward medical occurrence attributed to LYRICA Capsules in a participant who received LYRICA Capsules. Relatedness to LYRICA Capsules was assessed by the physician. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Percentage of Participants With Adverse Drug Reaction Unexpected From Japanese Package Insert | From Week 1 to 52 weeks | An adverse drug reaction (ADR) was any untoward medical occurrence attributed to LYRICA Capsules in a participant who received LYRICA Capsules. Expectedness of the adverse event was determined according to the Japanese package insert. Relatedness to LYRICA Capsules was assessed by the physician. |
| Number of Participants With Adverse Drug Reactions Related to Peripheral Edema or Other Edema-related Events | From Week 1 to 52 weeks | An adverse drug reaction (ADR) was any untoward medical occurrence attributed to LYRICA Capsules in a participant who received LYRICA Capsules. Relatedness to LYRICA Capsules was assessed by the physician. Occurrence of ADRs related to peripheral edema or other edema-related events was evaluated. |
| Number of Participants With Adverse Drug Reactions Related to Dizziness, Somnolence, Loss of Consciousness, Syncope, and Potential for Accidental Injury | From Week 1 to 52 weeks | An adverse drug reaction (ADR) was any untoward medical occurrence attributed to LYRICA Capsules in a participant who received LYRICA Capsules. Relatedness to LYRICA Capsules was assessed by the physician. Occurrence of ADRs related to dizziness, somnolence, loss of consciousness, syncope, and potential for accidental injury was evaluated. |
| Number of Participants With Adverse Drug Reactions Related to Vision-related Events | From Week 1 to 52 weeks | An adverse drug reaction (ADR) was any untoward medical occurrence attributed to LYRICA Capsules in a participant who received LYRICA Capsules. Relatedness to LYRICA Capsules was assessed by the physician. Occurrence of ADRs related to vision-related events was evaluated. |
| Change From Baseline in Pain Score at Week 52 | Baseline and at Week 52 | The pain from fibromyalgia experienced during the past 24 hours was rated by participants at the time of getting up in the morning on an 11-grade scale, ranging from 0 (no pain) to 10 (the most severe pain possible). Mean change from baseline in the pain score at Week 52 was presented along with standard deviation. |
| Change From Baseline in Quality of Sleep Score at Week 52 | Baseline and at Week 52 | The quality of sleep experienced during the past 24 hours was rated by participants at the time of getting up in the morning on an 11-grade scale, ranging from 0 (the best sleep possible) to 10 (the worst sleep possible). Mean change from baseline in quality of sleep score at Week 52 was presented along with standard deviation. |
| Percentage of Participants With Serious Adverse Drug Reaction | From Week 1 to52 weeks | An adverse drug reaction (ADR) was any untoward medical occurrence attributed to LYRICA Capsules in a participant who received LYRICA Capsules. A serious ADR was an ADR resulting in any of the following outcomes or deemed significant for any other reason: death; life-threatening experience (immediate risk of dying); initial or prolonged inpatient hospitalization; persistent or significant disability/incapacity; congenital anomaly. Relatedness to LYRICA Capsules was assessed by the physician. |
| Physician's Impression (CGIC) at Week 52 | At Week 52 | The physician's impression (clinical global impression of change \[CGIC\]) at Week 52, as compared to the baseline condition (including the first day of treatment), was rated by the physician on a 7-grade scale. |
| Change From Baseline in Patient Health Questionnaire (PHQ-9) Score at Week 52 | Baseline and at Week 52 | The problems associated with depression-related symptoms experienced during the last 2 weeks were rated by participants ranging from 0 (not at all) to 3 (nearly every day) in total 0 to 27(the higher the more severe) consisting the following 9 items: 1) little interest or pleasure in doing things; 2) depressed, or hopeless; 3) trouble falling or staying asleep, or sleeping too much; 4) feeling tired or having little energy; 5) poor appetite or overeating; 6) feeling bad about yourself - or that you are a failure or have let yourself or your family down; 7) trouble concentrating on things, such as reading the newspaper or watching television; 8) moving or speaking so slowly that other people could have noticed. Or the opposite - being so fidgety or restless that you have been moving around a lot more than usual; and 9) thoughts that you would be better off dead, or of hurting yourself. Mean change from baseline in the evaluation score was presented along with standard deviation. |
| Change From Baseline in Health Status of EuroQol 5 Dimension (EQ-5D) at 52 Weeks | Baseline and at Week 52 | Health status (EQ-5D) was evaluated based on the following 5 dimensions: mobility, self-care, usual activity (e.g., work, study, housework, family, or leisure activities), pain/discomfort, and anxiety/depression. Each dimension was rated in the three levels of response alternatives no problems, some problems, or extreme problems. For the analysis of EQ-5D, the response outcome for the five dimensions was converted to a utility value using tariff value set based on the Japanese version of EQ-5D. The utility value was not assigned if there was no response in any one of the five dimensions. 1 for full health and 0 for being dead: a positive (negative) number implies that the health state is better (worse) than dead. Mean change from baseline in the evaluation score was presented along with standard deviation. |
| Change From Baseline in Fibromyalgia Activity Score (FAS-31) at 52 Weeks | At Week 52 | FAS-31 (ranged from 0 to 31) is calculated as the combined score of the widespread pain index (WPI, ranged from 0 to 19) and the symptom severity (SS) scale (ranged from 0 to 12). The WPI is a measure of the number of painful body regions. The SS is the scale of the severity in the three symptoms (fatigue, waking unrefreshed, and cognitive symptoms; ranged from 0 to 3 each) and general physical symptoms (ranged from 0 to 3). WPI ranged from 0 to 19 the higher score indicates more severe of activity, SS ranged from 0-12 also higher score shows more severe symptoms observed. Mean change from baseline in the evaluation score was presented along with standard deviation. |
| Change From Baseline in the Japanese Version of the Revised Fibromyalgia Impact Questionnaire (JFIQR) at 52 Weeks | At Week 52 | JFIQR is a Japanese version of the Revised Fibromyalgia Impact Questionnaire (FIQR), which was established for overall evaluation of the influence of fibromyalgia on patient's health. It consists of three linked sets of domains: function (9 questions), overall impact (2 questions), and symptoms (10 questions). Participants responded to the questions based on an 11-grade scale, ranging from 0 to 10, with 10 being the worst. For the analysis of JFIQR, the score for each domain was modified as follows: The summed score for function (ranged from 0 to 90) was divided by 3 and the summed score for symptoms (ranged from 0 to 100) was divided by 2. The summed score for overall impact (ranged from 0 to 20) was not modified. The total score, the sum of the three modified domain scores (ranged from 0 to 100, the lower score represents a better outcome), was used for the analysis. Mean change from baseline in the evaluation score was presented along with standard deviation. |
| Patient's Impression (PGIC) at Week 52 | At Week 52 | The patient's impression (patient global impression of change \[PGIC\]) at Week 52, as compared to the baseline condition (including the first day of treatment), was rated by participants on a 7-grade scale. |
Participant flow
Participants by arm
| Arm | Count |
|---|---|
| LYRICA Capsules (Pregabalin) Participants who received LYRICA Capsules as indicated in the approved local product document were observed for a period of 52 weeks at maximum. The dosage can be adjusted as per physician's discretion. | 499 |
| Total | 499 |
Withdrawals & dropouts
| Period | Reason | FG000 |
|---|---|---|
| Overall Study | No Visit After Treatment | 35 |
Baseline characteristics
| Characteristic | LYRICA Capsules (Pregabalin) |
|---|---|
| Age, Customized ≥15 and <65 years | 392 Participants |
| Age, Customized <15 years | 1 Participants |
| Age, Customized ≥65 years | 106 Participants |
| Race/Ethnicity, Customized Race and Ethnicity Not Collected | 499 Participants |
| Sex/Gender, Customized Female | 408 Participants |
| Sex/Gender, Customized Male | 91 Participants |
Adverse events
| Event type | EG000 affected / at risk |
|---|---|
| deaths Total, all-cause mortality | 0 / 499 |
| other Total, other adverse events | 152 / 499 |
| serious Total, serious adverse events | 4 / 499 |
Outcome results
Percentage of Participants With Adverse Drug Reaction
An adverse drug reaction (ADR) was any untoward medical occurrence attributed to LYRICA Capsules in a participant who received LYRICA Capsules. Relatedness to LYRICA Capsules was assessed by the physician.
Time frame: From Week 1 to 52 weeks at maximum
Population: The analysis population for this outcome measure was the baseline analysis population, which comprised of participants who satisfied the criteria of safety analysis population and had received LYRICA Capsules at least once.
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| LYRICA Capsules (Pregabalin) | Percentage of Participants With Adverse Drug Reaction | 25.45 Percentage of Participants |
Change From Baseline in Fibromyalgia Activity Score (FAS-31) at 52 Weeks
FAS-31 (ranged from 0 to 31) is calculated as the combined score of the widespread pain index (WPI, ranged from 0 to 19) and the symptom severity (SS) scale (ranged from 0 to 12). The WPI is a measure of the number of painful body regions. The SS is the scale of the severity in the three symptoms (fatigue, waking unrefreshed, and cognitive symptoms; ranged from 0 to 3 each) and general physical symptoms (ranged from 0 to 3). WPI ranged from 0 to 19 the higher score indicates more severe of activity, SS ranged from 0-12 also higher score shows more severe symptoms observed. Mean change from baseline in the evaluation score was presented along with standard deviation.
Time frame: At Week 52
Population: The analysis population for this outcome measure comprised of participants for whom the evaluation outcome of FAS-31 was available among the baseline analysis population.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| LYRICA Capsules (Pregabalin) | Change From Baseline in Fibromyalgia Activity Score (FAS-31) at 52 Weeks | -5.2 Units on a scale | Standard Deviation 6.15 |
Change From Baseline in Health Status of EuroQol 5 Dimension (EQ-5D) at 52 Weeks
Health status (EQ-5D) was evaluated based on the following 5 dimensions: mobility, self-care, usual activity (e.g., work, study, housework, family, or leisure activities), pain/discomfort, and anxiety/depression. Each dimension was rated in the three levels of response alternatives no problems, some problems, or extreme problems. For the analysis of EQ-5D, the response outcome for the five dimensions was converted to a utility value using tariff value set based on the Japanese version of EQ-5D. The utility value was not assigned if there was no response in any one of the five dimensions. 1 for full health and 0 for being dead: a positive (negative) number implies that the health state is better (worse) than dead. Mean change from baseline in the evaluation score was presented along with standard deviation.
Time frame: Baseline and at Week 52
Population: The analysis population for this outcome measure comprised of participants for whom the evaluation outcome of EQ-5D was available among the baseline analysis population.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| LYRICA Capsules (Pregabalin) | Change From Baseline in Health Status of EuroQol 5 Dimension (EQ-5D) at 52 Weeks | 0.1 Units on a scale | Standard Deviation 0.19 |
Change From Baseline in Pain Score at Week 52
The pain from fibromyalgia experienced during the past 24 hours was rated by participants at the time of getting up in the morning on an 11-grade scale, ranging from 0 (no pain) to 10 (the most severe pain possible). Mean change from baseline in the pain score at Week 52 was presented along with standard deviation.
Time frame: Baseline and at Week 52
Population: The analysis population for this outcome measure comprised of participants for whom the evaluation outcome of pain score was available among the baseline analysis population.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| LYRICA Capsules (Pregabalin) | Change From Baseline in Pain Score at Week 52 | -2.4 Units on a scale | Standard Deviation 2.67 |
Change From Baseline in Patient Health Questionnaire (PHQ-9) Score at Week 52
The problems associated with depression-related symptoms experienced during the last 2 weeks were rated by participants ranging from 0 (not at all) to 3 (nearly every day) in total 0 to 27(the higher the more severe) consisting the following 9 items: 1) little interest or pleasure in doing things; 2) depressed, or hopeless; 3) trouble falling or staying asleep, or sleeping too much; 4) feeling tired or having little energy; 5) poor appetite or overeating; 6) feeling bad about yourself - or that you are a failure or have let yourself or your family down; 7) trouble concentrating on things, such as reading the newspaper or watching television; 8) moving or speaking so slowly that other people could have noticed. Or the opposite - being so fidgety or restless that you have been moving around a lot more than usual; and 9) thoughts that you would be better off dead, or of hurting yourself. Mean change from baseline in the evaluation score was presented along with standard deviation.
Time frame: Baseline and at Week 52
Population: The analysis population for this outcome measure comprised of participants for whom the evaluation outcome of PHQ-9 was available among the baseline analysis population.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| LYRICA Capsules (Pregabalin) | Change From Baseline in Patient Health Questionnaire (PHQ-9) Score at Week 52 | -3.4 Units on a scale | Standard Deviation 6.91 |
Change From Baseline in Quality of Sleep Score at Week 52
The quality of sleep experienced during the past 24 hours was rated by participants at the time of getting up in the morning on an 11-grade scale, ranging from 0 (the best sleep possible) to 10 (the worst sleep possible). Mean change from baseline in quality of sleep score at Week 52 was presented along with standard deviation.
Time frame: Baseline and at Week 52
Population: The analysis population for this outcome measure comprised of participants for whom the evaluation outcome of quality of sleep score was available among the baseline analysis population.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| LYRICA Capsules (Pregabalin) | Change From Baseline in Quality of Sleep Score at Week 52 | -1.4 Units on a scale | Standard Deviation 2.71 |
Change From Baseline in the Japanese Version of the Revised Fibromyalgia Impact Questionnaire (JFIQR) at 52 Weeks
JFIQR is a Japanese version of the Revised Fibromyalgia Impact Questionnaire (FIQR), which was established for overall evaluation of the influence of fibromyalgia on patient's health. It consists of three linked sets of domains: function (9 questions), overall impact (2 questions), and symptoms (10 questions). Participants responded to the questions based on an 11-grade scale, ranging from 0 to 10, with 10 being the worst. For the analysis of JFIQR, the score for each domain was modified as follows: The summed score for function (ranged from 0 to 90) was divided by 3 and the summed score for symptoms (ranged from 0 to 100) was divided by 2. The summed score for overall impact (ranged from 0 to 20) was not modified. The total score, the sum of the three modified domain scores (ranged from 0 to 100, the lower score represents a better outcome), was used for the analysis. Mean change from baseline in the evaluation score was presented along with standard deviation.
Time frame: At Week 52
Population: The analysis population for this outcome measure comprised of participants for whom the evaluation outcome of JFIQR was available among the baseline analysis population.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| LYRICA Capsules (Pregabalin) | Change From Baseline in the Japanese Version of the Revised Fibromyalgia Impact Questionnaire (JFIQR) at 52 Weeks | -15.2 Units on a scale | Standard Deviation 23.18 |
Number of Participants With Adverse Drug Reactions Related to Dizziness, Somnolence, Loss of Consciousness, Syncope, and Potential for Accidental Injury
An adverse drug reaction (ADR) was any untoward medical occurrence attributed to LYRICA Capsules in a participant who received LYRICA Capsules. Relatedness to LYRICA Capsules was assessed by the physician. Occurrence of ADRs related to dizziness, somnolence, loss of consciousness, syncope, and potential for accidental injury was evaluated.
Time frame: From Week 1 to 52 weeks
Population: The analysis population for this outcome measure was the baseline analysis population, which comprised of participants who satisfied the criteria of safety analysis population and had received LYRICA Capsules at least once.
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| LYRICA Capsules (Pregabalin) | Number of Participants With Adverse Drug Reactions Related to Dizziness, Somnolence, Loss of Consciousness, Syncope, and Potential for Accidental Injury | 65 Participants |
Number of Participants With Adverse Drug Reactions Related to Peripheral Edema or Other Edema-related Events
An adverse drug reaction (ADR) was any untoward medical occurrence attributed to LYRICA Capsules in a participant who received LYRICA Capsules. Relatedness to LYRICA Capsules was assessed by the physician. Occurrence of ADRs related to peripheral edema or other edema-related events was evaluated.
Time frame: From Week 1 to 52 weeks
Population: The analysis population for this outcome measure was the baseline analysis population, which comprised of participants who satisfied the criteria of safety analysis population and had received LYRICA Capsules at least once.
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| LYRICA Capsules (Pregabalin) | Number of Participants With Adverse Drug Reactions Related to Peripheral Edema or Other Edema-related Events | 6 Participants |
Number of Participants With Adverse Drug Reactions Related to Vision-related Events
An adverse drug reaction (ADR) was any untoward medical occurrence attributed to LYRICA Capsules in a participant who received LYRICA Capsules. Relatedness to LYRICA Capsules was assessed by the physician. Occurrence of ADRs related to vision-related events was evaluated.
Time frame: From Week 1 to 52 weeks
Population: The analysis population for this outcome measure was the baseline analysis population, which comprised of participants who satisfied the criteria of safety analysis population and had received LYRICA Capsules at least once.
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| LYRICA Capsules (Pregabalin) | Number of Participants With Adverse Drug Reactions Related to Vision-related Events | 5 Participants |
Patient's Impression (PGIC) at Week 52
The patient's impression (patient global impression of change \[PGIC\]) at Week 52, as compared to the baseline condition (including the first day of treatment), was rated by participants on a 7-grade scale.
Time frame: At Week 52
Population: The analysis population for this outcome measure comprised of participants for whom the evaluation outcome of PGIC was available among the baseline analysis population.
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| LYRICA Capsules (Pregabalin) | Patient's Impression (PGIC) at Week 52 | Markedly improved | 34 Participants |
| LYRICA Capsules (Pregabalin) | Patient's Impression (PGIC) at Week 52 | Improved | 79 Participants |
| LYRICA Capsules (Pregabalin) | Patient's Impression (PGIC) at Week 52 | Slightly improved | 119 Participants |
| LYRICA Capsules (Pregabalin) | Patient's Impression (PGIC) at Week 52 | Unchanged | 65 Participants |
| LYRICA Capsules (Pregabalin) | Patient's Impression (PGIC) at Week 52 | Slightly worsened | 6 Participants |
| LYRICA Capsules (Pregabalin) | Patient's Impression (PGIC) at Week 52 | Worsened | 3 Participants |
| LYRICA Capsules (Pregabalin) | Patient's Impression (PGIC) at Week 52 | Markedly worsened | 1 Participants |
| LYRICA Capsules (Pregabalin) | Patient's Impression (PGIC) at Week 52 | Not assessed | 109 Participants |
Percentage of Participants With Adverse Drug Reaction Unexpected From Japanese Package Insert
An adverse drug reaction (ADR) was any untoward medical occurrence attributed to LYRICA Capsules in a participant who received LYRICA Capsules. Expectedness of the adverse event was determined according to the Japanese package insert. Relatedness to LYRICA Capsules was assessed by the physician.
Time frame: From Week 1 to 52 weeks
Population: The analysis population for this outcome measure was the baseline analysis population, which comprised of participants who satisfied the criteria of safety analysis population and had received LYRICA Capsules at least once.
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| LYRICA Capsules (Pregabalin) | Percentage of Participants With Adverse Drug Reaction Unexpected From Japanese Package Insert | 3.41 Percentage of Participants |
Percentage of Participants With Serious Adverse Drug Reaction
An adverse drug reaction (ADR) was any untoward medical occurrence attributed to LYRICA Capsules in a participant who received LYRICA Capsules. A serious ADR was an ADR resulting in any of the following outcomes or deemed significant for any other reason: death; life-threatening experience (immediate risk of dying); initial or prolonged inpatient hospitalization; persistent or significant disability/incapacity; congenital anomaly. Relatedness to LYRICA Capsules was assessed by the physician.
Time frame: From Week 1 to52 weeks
Population: The analysis population for this outcome measure was the baseline analysis population, which comprised of participants who satisfied the criteria of safety analysis population and had received LYRICA Capsules at least once.
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| LYRICA Capsules (Pregabalin) | Percentage of Participants With Serious Adverse Drug Reaction | 0.20 Percentage of Participants |
Physician's Impression (CGIC) at Week 52
The physician's impression (clinical global impression of change \[CGIC\]) at Week 52, as compared to the baseline condition (including the first day of treatment), was rated by the physician on a 7-grade scale.
Time frame: At Week 52
Population: The analysis population for this outcome measure comprised of participants for whom the evaluation outcome of CGIC was available among the baseline analysis population.
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| LYRICA Capsules (Pregabalin) | Physician's Impression (CGIC) at Week 52 | Worsened | 2 Participants |
| LYRICA Capsules (Pregabalin) | Physician's Impression (CGIC) at Week 52 | Markedly worsened | 1 Participants |
| LYRICA Capsules (Pregabalin) | Physician's Impression (CGIC) at Week 52 | Markedly improved | 45 Participants |
| LYRICA Capsules (Pregabalin) | Physician's Impression (CGIC) at Week 52 | Improved | 105 Participants |
| LYRICA Capsules (Pregabalin) | Physician's Impression (CGIC) at Week 52 | Slightly improved | 121 Participants |
| LYRICA Capsules (Pregabalin) | Physician's Impression (CGIC) at Week 52 | Unchanged | 59 Participants |
| LYRICA Capsules (Pregabalin) | Physician's Impression (CGIC) at Week 52 | Slightly worsened | 4 Participants |
| LYRICA Capsules (Pregabalin) | Physician's Impression (CGIC) at Week 52 | Not assessed | 72 Participants |