Transient opioid use poses increased risk of acute COPD exacerbation
The transient use of opioids is strongly associated with acute respiratory exacerbation of chronic obstructive pulmonary disease (COPD), and this risk increases with the average daily opioid dose, a study has found.
The analysis included 1,354 adult patients and 1,972 COPD exacerbation events, with 62.27 percent of the qualifying events having an opioid prescription during the 7-day period prior. The mean age of the patients at the index exacerbation event was 53.11 years.
Researchers examined the frequency and dose of opioid exposure in the 7 days before the exacerbation and compared with opioid exposure in 10 control windows, each 7 days long, before the exacerbation. They performed conditional logistic regression analysis, with adjustments for use of bronchodilators, corticosteroids, benzodiazepines and beta-blockers.
Results showed that opioid exposure within 7 days before an exacerbation significantly correlated with acute respiratory exacerbation (odds ratio [OR], 1.81, 95 percent CI, 1.60–2.05). Furthermore, every 25-mg increase in morphine equivalent daily dose was associated with about a 10-percent risk increase (OR, 1.11, 1.04–1.20).
According to the researchers, the unique nature of the current case-crossover design facilitated demonstration of the clinical significance of the immediacy of the opioids risk.
Nevertheless, further studies should be conducted to explore the short-term risk of concomitant use of opioids and benzodiazepines on respiratory events in the COPD population, they added.