Gabapentinoids tied to risk of severe exacerbation in COPD: Study

Researchers from McGill University and Lady Davis Institute for Medical Research studied insurance data for 356 gabapentinoid users with epilepsy, 9,411 with neuropathic pain, and 3,737 with other chronic pain. The gabapentinoid users were matched 1:1 to nonusers on COPD duration, indication for gabapentinoids, age, sex, calendar year, and time-conditional propensity score. The authors found that compared with nonuse, gabapentinoid use was associated with an increased risk for severe COPD exacerbation among users taking these drugs for epilepsy, neuropathic pain, and chronic pain and peak increase in risk for severe COPD exacerbation occurred after approximately 6 months of continuous use. Among patients with neuropathic pain and other chronic pain, the risk was observed regardless of age, sex, number of prior COPD exacerbations, prior use of inhaled corticosteroids (ICS), number of respiratory medications used, or opioid or benzodiazepine use. According to the authors, physicians should consider these potential risks before prescribing gabapentin and pregabalin to patients with COPD.

Reference:

Alvi A. Rahman, MSc, Sophie Dell’Aniello, MSc, Erica E.M. Moodie,Gabapentinoids and Risk for Severe Exacerbation in Chronic Obstructive Pulmonary Disease, Annals of Internal Medicine, https://doi.org/10.7326/M23-0849.