Nefopam Misuse: A Cross-Sectional Study in France

IF 3.4 2区医学 Q1 ANESTHESIOLOGY

European Journal of Pain Pub Date : 2025-07-20 DOI:10.1002/ejp.70083

E. Barat, E. Lacroix, A. Gillibert, B. Gerard, P. Brevet, R. Leguillon, S. Pouplin, J. Grosjean, R. Varin

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引用次数: 0

Abstract

Background

Nefopam is a non-opioid analgesic. Nefopam is increasingly prescribed in contraindicated populations, raising questions about the appropriate use of nefopam. This study aimed to evaluate nefopam use in France according to age, epilepsy status and socioeconomic status.

Methods

This retrospective observational study was conducted from January 1, 2016, to December 31, 2022. Data on nefopam use in France were retrieved from the national health insurance information system.

Results

Between 2016 and 2022, 51.8 million boxes of nefopam were dispensed to 6.5 million patients, with a mean age of 56 years and a male-to-female sex ratio of 0.6. Nefopam use increased by 121.7%, whereas codeine use and tramadol use decreased by 7% and 17% respectively, raising the market share of nefopam from 5.0% to 11.6%. Nefopam use increased 2.8-fold in patients under 15 years and 1.7-fold in patients over 65 years, after standardisation. Nefopam use increased 1.7-fold in patients with epilepsy and 1.2-fold in patients with a disadvantaged socioeconomic status. The cost of nefopam was 4.3 times higher than alternative drugs. During the period 2016–2022, 8.23% of the general population received 1 to 4 boxes of nefopam per year, 4.68% received 6 to 19 boxes per year, and 0.91% received ≥ 20 boxes per year.

Conclusions

This study highlights a widespread inappropriate use of nefopam, especially in contraindicated populations and vulnerable groups. The recent availability of the oral form in France may worsen these patterns. Close national and European monitoring is important to assess the extent of such practices and guide future regulation.

Significance Statement

This work is a snapshot of nefopam usage in France. It sheds light on contraindicated uses (in subjects under 15 years of age or with epilepsy), not recommended uses (chronic usage, or in the elderly) and reports the usage of this treatment in the most deprived patients. This article cautions against underestimating the dangers and pitfalls of this treatment, especially in light of mounting evidence of pharmacodependence.

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尼福泮滥用：法国的横断面研究

Nefopam是一种非阿片类镇痛药。Nefopam越来越多地在禁忌人群中开处方，这引发了关于Nefopam适当使用的问题。本研究旨在根据年龄、癫痫状况和社会经济状况评估法国尼福泮的使用情况。方法回顾性观察研究时间为2016年1月1日至2022年12月31日。法国尼福泮使用的数据从国家健康保险信息系统中检索。结果2016 - 2022年，共发放尼福泮5180万盒，发放患者650万人次，平均年龄56岁，男女性别比为0.6。Nefopam的使用量增加了121.7%，而可待因和曲马多的使用量分别减少了7%和17%，Nefopam的市场份额从5.0%提高到11.6%。标准化后，15岁以下患者奈福泮使用量增加2.8倍，65岁以上患者使用量增加1.7倍。癫痫患者使用奈福泮增加1.7倍，社会经济地位较差的患者使用奈福泮增加1.2倍。尼福泮的费用是替代药物的4.3倍。2016-2022年期间，8.23%的普通人群每年收到1 - 4盒尼福泮，4.68%的人每年收到6 - 19盒，0.91%的人每年收到≥20盒。结论：本研究突出了尼福泮的广泛不当使用，特别是在禁忌症人群和弱势群体中。最近在法国口服形式的可用性可能使这些模式恶化。密切的国家和欧洲监测对于评估此类做法的程度和指导未来的监管非常重要。这项工作是法国尼福泮使用情况的快照。它阐明了禁忌症用途（15岁以下受试者或癫痫患者），不推荐用途（慢性使用，或老年人），并报告了这种治疗在最贫困患者中的使用情况。这篇文章警告不要低估这种治疗的危险和陷阱，特别是鉴于越来越多的药物依赖的证据。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

European Journal of Pain 医学-临床神经学

CiteScore

7.50

自引率

5.60%

发文量

163

审稿时长

4-8 weeks

期刊介绍： European Journal of Pain (EJP) publishes clinical and basic science research papers relevant to all aspects of pain and its management, including specialties such as anaesthesia, dentistry, neurology and neurosurgery, orthopaedics, palliative care, pharmacology, physiology, psychiatry, psychology and rehabilitation; socio-economic aspects of pain are also covered. Regular sections in the journal are as follows: • Editorials and Commentaries • Position Papers and Guidelines • Reviews • Original Articles • Letters • Bookshelf The journal particularly welcomes clinical trials, which are published on an occasional basis. Research articles are published under the following subject headings: • Neurobiology • Neurology • Experimental Pharmacology • Clinical Pharmacology • Psychology • Behavioural Therapy • Epidemiology • Cancer Pain • Acute Pain • Clinical Trials.