Active Ingredient: Gabapentin
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We explored the association between gabapentin and cancer in a United States US medical care program, and followed up nominally significant associations in a United Kingdom UK primary care database.
Methods In the US Kaiser Permanente Northern California KPNC health system, we performed nested case-control analyses of gabapentin and 55 cancer sites and all-cancer combined using conditional logistic regression.
Up to ten controls were matched to each case on year of birth, sex, and year of cohort entry.
No other covariates were included in models. Only dispensings for gabapentin 2 years or more prior to index date were considered.
These cancers were not statistically significantly associated with gabapentin in the GPRD case-control studies 2-year lag.
Conclusions The epidemiological data in a US cohort with up to 12 years of follow-up and a UK cohort with up to 15 years of follow up do not support a carcinogenic effect of gabapentin use. However, the confidence intervals for some analyses were wide, and an important effect cannot be confidently excluded.
Gabapentin has also been prescribed off-label for other pain conditions, 1 and is considered an adjunctive therapy for cancer pain according to the World Health Organization WHO analgesic ladder.
The association of gabapentin with cancer was evaluated in a case-control screening study of the association of 105 drugs with 55 cancers in Kaiser Permanente Northern California KPNC, 1994—.
This association was judged to be likely due to or substantially accentuated by confounding by cigarette smoking and hypertension. The current paper reports the full results of the KPNC study for gabapentin and each cancer.
The membership is fairly representative of the local population except for some under-representation of both extremes of the economic spectrum. The study design was a nested case-control study within a cohort of 6.
Cancer categories were based on invasive cancers at each cancer site plus non-invasive urinary bladder cancers listed in the International Classification of Diseases for Oncology, Version 3 ICD-O-3 except for non-melanoma skin cancers.
The index date was the date of incident cancer for cases. The index date for controls was chosen so as to give the controls equal follow-back time to that of the case for ascertainment of prior use of gabapentin.
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