The following is a summary of “Cyclobenzaprine utilization for musculoskeletal back pain: Analysis of 2007–2019 National Hospital Ambulatory Medical Care Survey Data,” published in the June 2023 issue of Emergency Medicine by Pourmand, et al.

Musculoskeletal back pain is a common complaint in the emergency department (ED), requiring evidence-based management strategies. Cyclobenzaprine, a muscle relaxant prescribed for musculoskeletal pain and muscle spasms, has been commonly used. However, recent literature questioning its efficacy has raised uncertainty about its role in managing musculoskeletal back pain. For a study, researchers sought to investigate trends in the utilization of cyclobenzaprine among patients presenting to the ED in the United States.

A retrospective cohort review of data from the National Hospital Ambulatory Medical Care Survey (NHAMCS) between 2007 and 2019 was conducted. ED visits of patients aged 18 years and older were analyzed. Visits during which cyclobenzaprine was administered in the ED or prescribed at discharge were identified. Trends were described using a time series analysis of patients’ visits receiving cyclobenzaprine administration and prescriptions.

Between 2007 and 2019, an estimated 1.35 billion ED visits were recorded, with 57.2% (772.6 million) female. From this sample, 2.4% (32.7 million) of all visits received cyclobenzaprine prescriptions in the ED only, and 0.5% (6.6 million) were given the drug in the ED and prescribed it at discharge. Overall, trend analysis showed a slight decrease in annual percentages of cyclobenzaprine administration and prescriptions during the study period. Specific subgroups, including those aged 26-44 years and white individuals, showed relatively higher percentages of cyclobenzaprine administration and prescription.

Despite some decrease, significant utilization of cyclobenzaprine in the ED was observed in our study, despite conflicting evidence regarding its efficacy for patients with musculoskeletal complaints and concerns about adverse effects. Further studies were needed to assess its effectiveness and risk-benefit analysis in treating patients with such conditions.

Source: sciencedirect.com/science/article/abs/pii/S0735675723001407