Safety of benzodiazepines and opioids in interstitial lung disease: a national prospective study
Sabrina Bajwah, Joanna M Davies, Hanan Tanash, David C Currow, Adejoke O Oluyase, Magnus Ekström, Sabrina Bajwah, Joanna M Davies, Hanan Tanash, David C Currow, Adejoke O Oluyase, Magnus Ekström
Abstract
Safety concerns are a barrier to prescribing benzodiazepines (BDZs) and opioids in interstitial lung disease (ILD). We therefore examined the association of BDZs and opioids on risk of admission to hospital and death.We conducted a population-based longitudinal cohort study of fibrotic ILD patients starting long-term oxygen therapy in Sweden between October 2005 and December 2014. Effects of BDZs and opioids on rates of admission to hospital and mortality were analysed using Fine-Gray and Cox regression while adjusting for potential confounders.We included 1603 patients (61% females). BDZs were used by 196 (12%) patients and opioids were used by 254 (15%) patients. There was no association between BDZs and increased admission. Treatment with high- versus low-dose BDZs was associated with increased mortality (subdistribution hazard ratio (SHR) 1.46, 95% CI 1.08-1.98 versus 1.13, 95% CI 0.92-1.38). Opioids showed no association with increased admission. Neither low-dose opioids (≤30 mg·day-1 oral morphine equivalent) (SHR 1.18, 95% CI 0.96-1.45) nor high-dose opioids (>30 mg·day-1 oral morphine equivalent) (SHR 1.11, 95% CI 0.89-1.39) showed association with increased mortality.This first ever study to examine associations between BDZ and opioid use and harm in ILD supports the use of opioids and low-dose BDZs in severely ill patients with respiratory compromise.
Conflict of interest statement
Conflict of interest: S. Bajwah has nothing to disclose. Conflict of interest: J.M. Davies has nothing to disclose. Conflict of interest: H. Tanash has nothing to disclose. Conflict of interest: D.C. Currow is an unpaid member of an advisory board for Helsinn Pharmaceuticals, is a consultant to Specialised Therapeutics and Mayne Pharma, and received intellectual property payments from Mayne Pharma. Conflict of interest: A.O. Oluyase has nothing to disclose. Conflict of interest: M. Ekström has nothing to disclose.
Copyright ©ERS 2018.
Source: PubMed