by A recent population-based cohort study consisting of over 10,000 individuals using gabapentinoids has revealed a concerning association between the use of these drugs and an increased risk of chronic obstructive pulmonary disease (COPD) exacerbation. The study, conducted by researchers from McGill University and the Lady Davis Institute for Medical Research, supports the warnings issued by regulatory agencies and highlights the importance of considering this potential risk when prescribing gabapentin and pregabalin to patients with COPD. The findings have been published in the Annals of Internal Medicine.
Gabapentinoids are anticonvulsant drugs primarily indicated for the treatment of epilepsy and neuropathic pain. However, despite their limited indications, their prescription rates have been surging across North America and Europe, largely due to excessive off-label prescribing. Nevertheless, previous animal and human studies have reported that these drugs can cause central nervous system depression, resulting in sedation and respiratory depression. Patients with respiratory diseases such as COPD may be particularly vulnerable to this safety issue.
To investigate the potential risks associated with gabapentinoid use, the researchers analyzed insurance data for 356 individuals using gabapentinoids for epilepsy, 9,411 for neuropathic pain, and 3,737 for other chronic pain conditions.
The gabapentinoid users were matched 1:1 with non-users based on COPD duration, indication for gabapentinoids, age, sex, calendar year, and time-conditional propensity score. The results showed that compared to non-use, gabapentinoid use significantly increased the risk of severe COPD exacerbation among users taking these drugs for epilepsy, neuropathic pain, and chronic pain. The peak increase in risk for severe COPD exacerbation occurred after approximately six months of continuous use.
Interestingly, the increased risk was observed in patients with neuropathic pain and other chronic pain conditions irrespective of their age, sex, prior history of COPD exacerbations, prior use of inhaled corticosteroids (ICS), number of respiratory medications used, and use of opioid or benzodiazepine medications. Based on these findings, the authors of the study suggest that physicians should carefully consider these potential risks before prescribing gabapentin and pregabalin to patients with COPD.
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- Source: Coherent Market Insights, Public sources, Desk research
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