慢性阻塞性肺疾病患者使用加巴喷丁类药物导致严重恶化的风险:一项基于人群的队列研究

IF 2.1 4区 医学 Q3 RESPIRATORY SYSTEM
Omotayo Olaoye, Sophie Dell'Aniello, Pierre Ernst, Samy Suissa, Christel Renoux
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引用次数: 0

摘要

慢性阻塞性肺疾病(COPD)患者与加巴喷丁类药物相关的不良呼吸结局风险的证据仍然有限。因此,我们的目的是评估与加巴喷丁类药物相关的严重COPD恶化的风险。我们使用英国临床实践研究数据链,与医院事件统计和国家统计办公室数据集相关联,收集了1993年至2021年间年龄≥55岁新诊断为COPD的患者的基础队列。使用时间条件倾向评分(TCPS)匹配的新用户设计,处方加巴喷丁类药物的患者有癫痫、神经性疼痛或其他慢性疼痛的适应症,与年龄、性别、日历年、COPD持续时间和TCPS相同适应症的非使用者进行1:1匹配。Cox比例风险模型用于估计整个队列中使用加巴喷丁类药物与未使用加巴喷丁类药物相关的严重恶化的风险比(HR)和95%置信区间(CIs),并根据适应症进行评估。该研究队列包括29,882名加巴喷丁类药物使用者,其中癫痫患者1,256名,神经性疼痛患者19,155名,其他慢性疼痛患者9,471名,与非使用者比例为1:1。与未使用相比,加巴喷丁类药物的使用与整个队列中严重恶化的风险增加相关(HR 1.43;95% CI: 1.35-1.52),癫痫患者(HR 1.39;95% CI: 1.11-1.74),神经性疼痛(HR 1.43;95% CI: 1.32-1.54)和其他慢性疼痛(HR 1.45;95% ci: 1.31-1.60)。这些发现表明,加巴喷丁类药物的使用与慢性阻塞性肺病患者严重恶化的风险增加有关,这与神经性疼痛、癫痫和其他慢性疼痛患者的情况一致。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Risk of Severe Exacerbation Associated with Gabapentinoid Use in Patients with Chronic Obstructive Pulmonary Disease: A Population-Based Cohort Study.

Evidence on the risk of adverse respiratory outcomes associated with gabapentinoids in patients with chronic obstructive pulmonary disease (COPD) remains limited. Thus, we aimed to assess the risk of severe COPD exacerbation associated with gabapentinoids. We assembled a base cohort of patients aged ≥ 55 years newly diagnosed with COPD between 1993 and 2021 using the UK's Clinical Practice Research Datalink, linked to the Hospital Episode Statistics, and Office for National Statistics datasets. Using a time-conditional propensity score (TCPS)-matched, new-user design, patients prescribed gabapentinoids with an indication of epilepsy, neuropathic pain, or other chronic pain were matched 1:1 with non-users with the same indication on age, sex, calendar year, COPD duration, and TCPS. Cox proportional hazards models were used to estimate the hazard ratios (HR) and 95% confidence intervals (CIs) of severe exacerbation associated with gabapentinoid use compared to non-use in the overall cohort, and by indication. The study cohort comprised 29,882 gabapentinoid users, including 1,256 with epilepsy, 19,155 patients with neuropathic pain, and 9,471 with other chronic pain matched 1:1 with non-users. Compared with non-use, gabapentinoid use was associated with an increased risk of severe exacerbation in the overall cohort (HR 1.43; 95% CI: 1.35-1.52), and among patients with epilepsy (HR 1.39; 95% CI: 1.11-1.74), neuropathic pain (HR 1.43; 95% CI: 1.32-1.54), and other chronic pain (HR 1.45; 95% CI: 1.31-1.60). These findings suggest that gabapentinoid use is associated with an increased risk of severe exacerbation among patients with COPD, consistent among patients with neuropathic pain, epilepsy, and other chronic pain.

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来源期刊
CiteScore
4.40
自引率
0.00%
发文量
38
审稿时长
6-12 weeks
期刊介绍: From pathophysiology and cell biology to pharmacology and psychosocial impact, COPD: Journal Of Chronic Obstructive Pulmonary Disease publishes a wide range of original research, reviews, case studies, and conference proceedings to promote advances in the pathophysiology, diagnosis, management, and control of lung and airway disease and inflammation - providing a unique forum for the discussion, design, and evaluation of more efficient and effective strategies in patient care.
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