加巴丁类药物和慢性阻塞性肺部疾病严重恶化的风险:基于人口的队列研究
Alvi A Rahman1, Sophie Dell'Aniello2, Erica E M Moodie3
1Department of Epidemiology, Biostatistics and Occupational Health, McGill University, and Centre for Clinical Epidemiology, Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada (A.A.R., J.-F.B.).
Annals of internal medicine
|January 15, 2024
概括
使用 gabapentinoid 显著增加了慢性阻塞性肺病 (COPD) 患者严重恶化的风险. 这一发现支持卫生机构对COPD患者使用这些药物的警告.
科学领域:
- 肺部医学 肺部医学
- 药理学 药理学是指药理学的学科.
- 临床流行病学 临床流行病学
背景情况:
- 卫生机构对慢性阻塞性肺病 (COPD) 患者与 gabapentinoids 相关的严重呼吸问题发出警告.
- 这些警告的支持证据以前是有限的,需要进一步调查.
研究的目的:
- 为了研究 gabapentinoid 使用与COPD 诊断患者严重恶化之间的关联.
- 提供经验证据来支持或反驳现有的COPD患者对 gabapentinoids 的健康建议.
主要方法:
- 使用加拿大医疗保险数据库进行了一项时间条件倾向得分匹配的新用户队列研究.
- 开始 gabapentinoid 治疗的 COPD 患者与基于各种临床和人口因素的非使用者进行了 1:1 的匹配.
主要成果:
- 使用 gabapentinoid 与所有研究的适应症中严重的COPD恶化风险显著增加有关: (HR, 1.58),神经病痛 (HR, 1.35) 和其他慢性疼痛 (HR, 1.49).
- 整体分析表明,与非使用者相比, gabapentinoid 用户的严重COPD恶化风险增加了 39% (HR,1.39).
结论:
- gabapentinoid的使用与COPD患者严重恶化的风险更高有关.
- 这些发现证实了监管机构的警告,并强调在给COPD患者开 gabapentin 和 pregabalin 处方时需要谨慎.
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