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Transient opioid use poses increased risk of acute COPD exacerbation

02 Sep 2019

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.

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Most Read Articles
Elvira Manzano, 4 days ago

The US Preventive Services Task Force (USPSTF), in an update of its 2013 recommendations, called on clinicians to offer risk-reducing medications to women who are at increased risk for breast cancer but at low risk for adverse effects.

Pearl Toh, 5 days ago
The use of SGLT-2* inhibitors was not associated with a higher risk of severe or nonsevere urinary tract infections (UTIs) in patients with type 2 diabetes (T2D) compared with DPP**-4 inhibitors or GLP-1*** receptor agonists, a population-based cohort study shows.
Yesterday
Cryptococcosis is more common in nonhuman immunodeficiency virus (HIV) nontransplant (NHNT) patients, and this population tends to have more localized pulmonary cryptococcosis and significantly higher 90-day mortality, reports a study.
5 days ago
Type 2 diabetes (T2D) is an independent risk factor for all-cause dementia, with the greatest risk observed in patients who are insulin-dependent and obese, a recent study has found.