Mirogabalin has been attracting attention for treating peripheral neuropathic pain. The package insert recommends that mirogabalin should be titrated depending on renal function. Here, we investigated the relationship between dose titration patterns and adherence, and persistence of mirogabalin treatment. Peripheral neuropathic pain patients who initiated mirogabalin between March 2020 and May 2021 were identified using an electronic medical record database. The dose titration pattern was described according to degrees of renal function. Regression analyses were performed to compare adherence and persistence between the patients with and without titration. Of the 4,138 identified patients, 1,696 (41.0%) titrated the dose within 45 days and were more adherent than those without titration (Adjusted odds ratio: 1.75, 95% CI 1.21, 2.54). Of the total 952 patients with renal function parameters, 229 (24.1%) titrated to the effective dose within 45 days and were less likely to discontinue than those without titration (Adjusted hazard ratio: 0.57, 95% CI 0.40, 0.81). Mirogabalin dose titration was associated with better adherence and persistence. It is important for mirogabalin treatment to determine the initial prescription dose based on renal function and subsequent dose titration according to the package insert. UMIN000047313.

Aim: Kampo medicines, which are covered under national health insurance, are widely accessible and affordable in Japan; however, knowledge about their current prescription practices remains limited. This study investigated the outpatient prescription practices of Kampo formulations at Kyoto University Hospital from April 2011 to March 2023. Results: Kampo medicine was prescribed in all medical departments. A total of 42,453 prescriptions were recorded during the study period, with an average of 3,538 prescriptions per year. The gynecology and obstetrics department had the highest number of Kampo prescriptions, followed by anesthesiology. The anesthesiology department prescribed various formulations for 12 years. The usage rate of Processed Aconite Root-containing formulations increased with increasing patient age, reaching 3.3% in individuals in their teens, 6.6% in their twenties, 13.3% in their thirties, and over 30% in their eighties and nineties. Conclusion: The substantial use of Kampo medicines across various departments indicates their critical role in specialized and general medical practice. The adaptability and personalized approach of treatments using Kampo medicines in the anesthesiology department are evident from the dynamic prescription patterns. Notably, the increasing use of Processed Aconite Root-containing formulations with advancing patient age suggests a potential age-related preference or therapeutic indication. These findings underscore the integral role of Kampo medicine in modern clinical practice and emphasize the necessity of further research into its age-specific applications and departmental prescribing trends.