Gabapentinoid to Loop Diuretic Prescribing Cascade: A Systematic Review and Meta-Analysis of Observational Studies

Gabapentinoid initiation is associated with increased loop diuretic prescribing in adults, with a pooled adjusted sequence ratio of 1.37 (95% CI 1.14–1.64) across five studies.

• Why it matters: The prescribing-cascade concern is that gabapentinoid-related peripheral edema may be treated as a new condition, potentially leading to unnecessary downstream harms.
• What they did: A systematic review and meta-analysis of observational studies (nine studies; >1.8 million new gabapentinoid users; five countries) pooled adjusted sequence ratios using random-effects methods.
• The result: Sequence ratios ranged from 1.23 to 1.69, higher doses showed larger estimates in four of five dose analyses, and one chart review found 23.3% potential harm within 60 days.

AI summary of the abstract · may contain errors · not medical advice · read the paper.