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Poppers Use and High Methaemoglobinaemia: 'Dangerous Liaisons'
Malcolm Barrangou-Poueys-Darlas1, Marie Gerardin1, Sylvie Deheul2
1Centre for Evaluation and Information on Pharmacodependence, Clinical Pharmacology Department, Nantes University Hospital, 9 Quai Monsousu, 44000 Nantes, France.
Pharmaceuticals (Basel, Switzerland)
|October 23, 2021
Summary
Poppers use is linked to methaemoglobinaemia (MetHbia), a severe side effect. Following legalization in France, poppers consumption increased among patients with MetHbia, particularly those with severe cases.
Area of Science:
- Toxicology
- Pharmacovigilance
- Public Health
Background:
- Poppers, alkyl nitrites, are widely used in France.
- Severe adverse effects, including methaemoglobinaemia (MetHbia), are associated with poppers.
- The legalization of poppers in France prompted an investigation into their health impacts.
Purpose of the Study:
- To determine the prevalence of poppers consumption in patients with MetHbia (≥5%) in French university hospitals.
- To analyze the evolution of poppers consumption and MetHbia prevalence before and after legalization.
- To assess the association between poppers use and severe MetHbia (≥25%).
Main Methods:
- National multicentre observational retrospective study.
- Inclusion of patients with MetHbia measurements (2012-2017) in French addictovigilance network (FAN) hospitals.
- Clinical file review by FAN to identify poppers consumption in MetHbia cases (≥5%).
Main Results:
- 239 patients (0.14%) had MetHbia ≥5%, with 25 cases (10.46%) linked to poppers.
- Poppers consumption was high in severe MetHbia (≥25%), accounting for 68.4% of cases.
- Post-legalization, poppers use in MetHbia (≥5%) patients rose from 4.76% to 11.67% (PR=2.45).
- Severe MetHbia (≥25%) cases also increased post-legalization (4.76% to 8.63%, PR=1.81).
Conclusions:
- Poppers use is a significant factor in MetHbia, especially severe cases (≥25%).
- Legalization in France correlated with an increase in poppers consumption among MetHbia patients.
- Continued monitoring and public health awareness regarding poppers' risks are crucial.
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