The use of gabapentinoids and opioids and risk of developing opioid-induced respiratory depression among older breast cancer survivors with neuropathic pain
Purpose To estimate the combined effect of gabapentinoid and opioid therapy compared to opioid monotherapy on the risk of developing opioid-induced respiratory depression among breast cancer survivors with neuropathic pain. Method A nested case–control study of Medicare female breast cancer survivor...
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| Veröffentlicht in: | Journal of cancer survivorship 2024-06, Vol.18 (3), p.917-927 |
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| creator | Lakkad, Mrinmayee Martin, Bradley Li, Chenghui Harrington, Sarah Dayer, Lindsey Painter, Jacob T. |
| description | Purpose
To estimate the combined effect of gabapentinoid and opioid therapy compared to opioid monotherapy on the risk of developing opioid-induced respiratory depression among breast cancer survivors with neuropathic pain.
Method
A nested case–control study of Medicare female breast cancer survivors with neuropathic pain receiving both opioids and gabapentinoids, opioid monotherapy, gabapentinoid monotherapy, and none of these drugs was conducted using SEER-Medicare between 2007 and 2015. Cases were survivors with respiratory depression and were matched with controls on the event date (± 1 year), age at diagnosis (± 5 years), and stage at diagnosis. Exposure to opioids and gabapentinoids was assessed 120 days before the event date. Conditional logistic regression was used to assess the impact of exposure among cases and controls.
Results
A total of 657 cases and 11,471 controls were identified. After matching, 656 cases and 5612 controls were retained, and cases were more likely to be diagnosed with mental health disorders (24.4% vs 10.5%,
p
|
| doi_str_mv | 10.1007/s11764-023-01338-9 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2774498911</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>3052957743</sourcerecordid><originalsourceid>FETCH-LOGICAL-c375t-aef8185482575cf81c613f1ac0723f094857d4f1293f0a9f6e13f8f1a64b52ae3</originalsourceid><addsrcrecordid>eNp9kc1u2zAQhIkiQZMmfYEeAgK59KKGP6IoHoOgf0CAXpIzQVMrm6lMKlzJgd-lD1u6dl0gh544g_l2SXAI-cDZJ86YvkHOdVNXTMiKcSnbyrwh59xIUQnR6JOjVuaMvEN8YkwJw8VbciYbrSRj8pz8elgBnRFo6unSLdwIcQoxhQ6pix1NYzjqHPDnDutgA0MJ4vIQVyF2s4dCAI4huynlbaHGYjGkSN067dihg0wXGRxO1Lvoi8M5b8ImZaQvYVrRCHNOo5tWwdPRhXhJTns3ILw_nBfk8cvnh7tv1f2Pr9_vbu8rL7WaKgd9y1tVt0Jp5Yv2DZc9d55pIXtm6lbpru65MMU50zdQ4rYATb1QwoG8IB_3e8ecnmfAya4DehgGFyHNaIXWdW1aw3lBr1-hT2nOsbzOyt33qoLKQok95XNCzNDbMYe1y1vLmd11Z_fd2dKd_dOdNWXo6rB6XqyhO478LasAcg9gieIS8r-7_7P2N84kp4A</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>3052957743</pqid></control><display><type>article</type><title>The use of gabapentinoids and opioids and risk of developing opioid-induced respiratory depression among older breast cancer survivors with neuropathic pain</title><source>SpringerLink Journals - AutoHoldings</source><creator>Lakkad, Mrinmayee ; Martin, Bradley ; Li, Chenghui ; Harrington, Sarah ; Dayer, Lindsey ; Painter, Jacob T.</creator><creatorcontrib>Lakkad, Mrinmayee ; Martin, Bradley ; Li, Chenghui ; Harrington, Sarah ; Dayer, Lindsey ; Painter, Jacob T.</creatorcontrib><description>Purpose
To estimate the combined effect of gabapentinoid and opioid therapy compared to opioid monotherapy on the risk of developing opioid-induced respiratory depression among breast cancer survivors with neuropathic pain.
Method
A nested case–control study of Medicare female breast cancer survivors with neuropathic pain receiving both opioids and gabapentinoids, opioid monotherapy, gabapentinoid monotherapy, and none of these drugs was conducted using SEER-Medicare between 2007 and 2015. Cases were survivors with respiratory depression and were matched with controls on the event date (± 1 year), age at diagnosis (± 5 years), and stage at diagnosis. Exposure to opioids and gabapentinoids was assessed 120 days before the event date. Conditional logistic regression was used to assess the impact of exposure among cases and controls.
Results
A total of 657 cases and 11,471 controls were identified. After matching, 656 cases and 5612 controls were retained, and cases were more likely to be diagnosed with mental health disorders (24.4% vs 10.5%,
p
< 0.0001) than controls. In the primary adjusted analysis, combined opioids and gabapentin use were associated with an increased risk of respiratory depression compared to opioid monotherapy (Adj. OR: 1.513; 95% CI: 1.473–2.350). Additionally, under secondary analysis, combined opioids and gabapentin use were associated with an increased risk of respiratory depression compared to receiving neither of these classes. (Adj. OR: 1.595; 95% CI: 1.050–2.421).
Conclusion
There is a need for dose titration strategies of gabapentinoids and caution when co-prescribing opioids and gabapentinoids in older cancer survivors.</description><identifier>ISSN: 1932-2259</identifier><identifier>EISSN: 1932-2267</identifier><identifier>DOI: 10.1007/s11764-023-01338-9</identifier><identifier>PMID: 36753003</identifier><language>eng</language><publisher>New York: Springer US</publisher><subject>Breast cancer ; Diagnosis ; Gabapentin ; Health Informatics ; Health Promotion and Disease Prevention ; Medicare ; Medicine ; Medicine & Public Health ; Mental depression ; Narcotics ; Neuralgia ; Oncology ; Opioids ; Pain ; Primary Care Medicine ; Public Health ; Quality of Life Research ; Risk ; Secondary analysis ; Survival ; Titration</subject><ispartof>Journal of cancer survivorship, 2024-06, Vol.18 (3), p.917-927</ispartof><rights>This is a U.S. Government work and not under copyright protection in the US; foreign copyright protection may apply 2023</rights><rights>2023. This is a U.S. Government work and not under copyright protection in the US; foreign copyright protection may apply.</rights><rights>This is a U.S. Government work and not under copyright protection in the US; foreign copyright protection may apply 2023.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c375t-aef8185482575cf81c613f1ac0723f094857d4f1293f0a9f6e13f8f1a64b52ae3</citedby><cites>FETCH-LOGICAL-c375t-aef8185482575cf81c613f1ac0723f094857d4f1293f0a9f6e13f8f1a64b52ae3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s11764-023-01338-9$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s11764-023-01338-9$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27924,27925,41488,42557,51319</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/36753003$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Lakkad, Mrinmayee</creatorcontrib><creatorcontrib>Martin, Bradley</creatorcontrib><creatorcontrib>Li, Chenghui</creatorcontrib><creatorcontrib>Harrington, Sarah</creatorcontrib><creatorcontrib>Dayer, Lindsey</creatorcontrib><creatorcontrib>Painter, Jacob T.</creatorcontrib><title>The use of gabapentinoids and opioids and risk of developing opioid-induced respiratory depression among older breast cancer survivors with neuropathic pain</title><title>Journal of cancer survivorship</title><addtitle>J Cancer Surviv</addtitle><addtitle>J Cancer Surviv</addtitle><description>Purpose
To estimate the combined effect of gabapentinoid and opioid therapy compared to opioid monotherapy on the risk of developing opioid-induced respiratory depression among breast cancer survivors with neuropathic pain.
Method
A nested case–control study of Medicare female breast cancer survivors with neuropathic pain receiving both opioids and gabapentinoids, opioid monotherapy, gabapentinoid monotherapy, and none of these drugs was conducted using SEER-Medicare between 2007 and 2015. Cases were survivors with respiratory depression and were matched with controls on the event date (± 1 year), age at diagnosis (± 5 years), and stage at diagnosis. Exposure to opioids and gabapentinoids was assessed 120 days before the event date. Conditional logistic regression was used to assess the impact of exposure among cases and controls.
Results
A total of 657 cases and 11,471 controls were identified. After matching, 656 cases and 5612 controls were retained, and cases were more likely to be diagnosed with mental health disorders (24.4% vs 10.5%,
p
< 0.0001) than controls. In the primary adjusted analysis, combined opioids and gabapentin use were associated with an increased risk of respiratory depression compared to opioid monotherapy (Adj. OR: 1.513; 95% CI: 1.473–2.350). Additionally, under secondary analysis, combined opioids and gabapentin use were associated with an increased risk of respiratory depression compared to receiving neither of these classes. (Adj. OR: 1.595; 95% CI: 1.050–2.421).
Conclusion
There is a need for dose titration strategies of gabapentinoids and caution when co-prescribing opioids and gabapentinoids in older cancer survivors.</description><subject>Breast cancer</subject><subject>Diagnosis</subject><subject>Gabapentin</subject><subject>Health Informatics</subject><subject>Health Promotion and Disease Prevention</subject><subject>Medicare</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Mental depression</subject><subject>Narcotics</subject><subject>Neuralgia</subject><subject>Oncology</subject><subject>Opioids</subject><subject>Pain</subject><subject>Primary Care Medicine</subject><subject>Public Health</subject><subject>Quality of Life Research</subject><subject>Risk</subject><subject>Secondary analysis</subject><subject>Survival</subject><subject>Titration</subject><issn>1932-2259</issn><issn>1932-2267</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><recordid>eNp9kc1u2zAQhIkiQZMmfYEeAgK59KKGP6IoHoOgf0CAXpIzQVMrm6lMKlzJgd-lD1u6dl0gh544g_l2SXAI-cDZJ86YvkHOdVNXTMiKcSnbyrwh59xIUQnR6JOjVuaMvEN8YkwJw8VbciYbrSRj8pz8elgBnRFo6unSLdwIcQoxhQ6pix1NYzjqHPDnDutgA0MJ4vIQVyF2s4dCAI4huynlbaHGYjGkSN067dihg0wXGRxO1Lvoi8M5b8ImZaQvYVrRCHNOo5tWwdPRhXhJTns3ILw_nBfk8cvnh7tv1f2Pr9_vbu8rL7WaKgd9y1tVt0Jp5Yv2DZc9d55pIXtm6lbpru65MMU50zdQ4rYATb1QwoG8IB_3e8ecnmfAya4DehgGFyHNaIXWdW1aw3lBr1-hT2nOsbzOyt33qoLKQok95XNCzNDbMYe1y1vLmd11Z_fd2dKd_dOdNWXo6rB6XqyhO478LasAcg9gieIS8r-7_7P2N84kp4A</recordid><startdate>20240601</startdate><enddate>20240601</enddate><creator>Lakkad, Mrinmayee</creator><creator>Martin, Bradley</creator><creator>Li, Chenghui</creator><creator>Harrington, Sarah</creator><creator>Dayer, Lindsey</creator><creator>Painter, Jacob T.</creator><general>Springer US</general><general>Springer Nature B.V</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7TO</scope><scope>H94</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7X8</scope></search><sort><creationdate>20240601</creationdate><title>The use of gabapentinoids and opioids and risk of developing opioid-induced respiratory depression among older breast cancer survivors with neuropathic pain</title><author>Lakkad, Mrinmayee ; Martin, Bradley ; Li, Chenghui ; Harrington, Sarah ; Dayer, Lindsey ; Painter, Jacob T.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c375t-aef8185482575cf81c613f1ac0723f094857d4f1293f0a9f6e13f8f1a64b52ae3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Breast cancer</topic><topic>Diagnosis</topic><topic>Gabapentin</topic><topic>Health Informatics</topic><topic>Health Promotion and Disease Prevention</topic><topic>Medicare</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Mental depression</topic><topic>Narcotics</topic><topic>Neuralgia</topic><topic>Oncology</topic><topic>Opioids</topic><topic>Pain</topic><topic>Primary Care Medicine</topic><topic>Public Health</topic><topic>Quality of Life Research</topic><topic>Risk</topic><topic>Secondary analysis</topic><topic>Survival</topic><topic>Titration</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Lakkad, Mrinmayee</creatorcontrib><creatorcontrib>Martin, Bradley</creatorcontrib><creatorcontrib>Li, Chenghui</creatorcontrib><creatorcontrib>Harrington, Sarah</creatorcontrib><creatorcontrib>Dayer, Lindsey</creatorcontrib><creatorcontrib>Painter, Jacob T.</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>Oncogenes and Growth Factors Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of cancer survivorship</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Lakkad, Mrinmayee</au><au>Martin, Bradley</au><au>Li, Chenghui</au><au>Harrington, Sarah</au><au>Dayer, Lindsey</au><au>Painter, Jacob T.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The use of gabapentinoids and opioids and risk of developing opioid-induced respiratory depression among older breast cancer survivors with neuropathic pain</atitle><jtitle>Journal of cancer survivorship</jtitle><stitle>J Cancer Surviv</stitle><addtitle>J Cancer Surviv</addtitle><date>2024-06-01</date><risdate>2024</risdate><volume>18</volume><issue>3</issue><spage>917</spage><epage>927</epage><pages>917-927</pages><issn>1932-2259</issn><eissn>1932-2267</eissn><abstract>Purpose
To estimate the combined effect of gabapentinoid and opioid therapy compared to opioid monotherapy on the risk of developing opioid-induced respiratory depression among breast cancer survivors with neuropathic pain.
Method
A nested case–control study of Medicare female breast cancer survivors with neuropathic pain receiving both opioids and gabapentinoids, opioid monotherapy, gabapentinoid monotherapy, and none of these drugs was conducted using SEER-Medicare between 2007 and 2015. Cases were survivors with respiratory depression and were matched with controls on the event date (± 1 year), age at diagnosis (± 5 years), and stage at diagnosis. Exposure to opioids and gabapentinoids was assessed 120 days before the event date. Conditional logistic regression was used to assess the impact of exposure among cases and controls.
Results
A total of 657 cases and 11,471 controls were identified. After matching, 656 cases and 5612 controls were retained, and cases were more likely to be diagnosed with mental health disorders (24.4% vs 10.5%,
p
< 0.0001) than controls. In the primary adjusted analysis, combined opioids and gabapentin use were associated with an increased risk of respiratory depression compared to opioid monotherapy (Adj. OR: 1.513; 95% CI: 1.473–2.350). Additionally, under secondary analysis, combined opioids and gabapentin use were associated with an increased risk of respiratory depression compared to receiving neither of these classes. (Adj. OR: 1.595; 95% CI: 1.050–2.421).
Conclusion
There is a need for dose titration strategies of gabapentinoids and caution when co-prescribing opioids and gabapentinoids in older cancer survivors.</abstract><cop>New York</cop><pub>Springer US</pub><pmid>36753003</pmid><doi>10.1007/s11764-023-01338-9</doi><tpages>11</tpages></addata></record> |
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| ispartof | Journal of cancer survivorship, 2024-06, Vol.18 (3), p.917-927 |
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| subjects | Breast cancer Diagnosis Gabapentin Health Informatics Health Promotion and Disease Prevention Medicare Medicine Medicine & Public Health Mental depression Narcotics Neuralgia Oncology Opioids Pain Primary Care Medicine Public Health Quality of Life Research Risk Secondary analysis Survival Titration |
| title | The use of gabapentinoids and opioids and risk of developing opioid-induced respiratory depression among older breast cancer survivors with neuropathic pain |
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