オピオイドとベンゾジアゼピン/Z薬の処方に関連したガバペンチン処方事件 - プライマリケアにおける集団ベースの長期研究
Kristjan Linnet1, Bjarni Pall Linnet Runolfsson2, Johann Agust Sigurdsson1,3
1Development Centre for Primary Healthcare in Iceland, Primary Healthcare of the Capital Area, Reykjavik, Iceland.
Frontiers in pharmacology
|August 29, 2025
まとめ
オピオイド,ベンゾジアゼピン,Z薬の長期使用は,将来のガバペンチン処方薬のリスクを高めます. これらの薬剤を多く使用した患者は,ガバペンチン投与を開始し,より長く使用する可能性が最も高かった.
科学分野:
- 薬用警戒について
- 臨床薬局
- 公衆衛生
背景:
- オピオイド,ベンゾジアゼピン (BZD),Z薬は,様々な状態のために一般的に処方されています.
- ガバペンチン処方量は増加しており,関連する危険因子の理解が必要である.
- 特定の薬剤の長期使用は,新しい薬剤治療の開始に影響を与える可能性があります.
研究 の 目的:
- オピオイド,ベンゾジアゼピン,Z薬の長期処方とガバペンチン処方後の発生率との関連を調査する.
- ガバペンチンの開始と使用期間に対する以前の薬剤使用の影響を調査する.
主な方法:
- アイスランドのレイキャビックで10歳から69歳の94,840人の患者さんを対象に実施した遡及コホート研究 (2009年−2012年).
- 薬物使用 (オピオイド,BZD,Z薬,ガバペンチン) と併発症に関するデータは,電子医療記録と国家医薬品登録簿から抽出した.
- ガバペンチン処方の発生率比 (IRR) を評価するために,コックス回帰分析を使用した.
主要な成果:
- オピオイド,BZD,またはZ薬の長期使用は,将来のガバペンチン使用のリスクの増加と有意に関連していました.
- BZDsまたはZ薬の最も高い以前の使用量 (≥30定義日用量) の患者は,ガバペンチンを開始する可能性が最も高い (IRR 7. 18) でした.
- これらの薬剤を大量に服用した後にガバペンチン投与を開始した個体でも,ガバペンチン投与の平均期間は最も長かった.
結論:
- 以前から長期にわたるオピオイド,ベンゾジアゼピン,Z型薬の使用は,ガバペンチン治療を開始する際の重要なリスク因子です.
- ガバペンチン処方薬の増加は,特にこれらの他の薬剤の長期使用歴のある患者において,注意深いモニタリングを必要とします.
- 医療提供者は,この関連性を考慮して,潜在的な問題のあるガバペンチン使用を緩和する必要があります.
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