Abstract
Safety concerns are a barrier to prescribing benzodiazepines (BDZ) and opioids in Interstitial Lung Disease (ILD). We therefore examined association of BDZ 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 2005–2014. Effects of BDZ and opioids on rates of admission to hospital and mortality were analysed using Fine-Gray and Cox regression whilst adjusting for potential confounders.
We included 1603 patients (61% women). BDZ were used by 196 (12%), opioids by 254 (15%). There was no association between BDZ and increased admission. Treatment with higher versus lower dose BDZ was associated with increased mortality: (SHR 1·46, 95% CI 1·08–1·98) versus (SHR 1·13, 95% CI 0·92–1·38). Opioids showed no association with increased admission. Neither low dose opioids (<30 mg·day−1 morphine equivalent) (SHR 1·18 (95% CI 0.96–1·45) nor high dose opioids (>30 mg·day−1 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 BDZ in severely ill patients with respiratory compromise.
Footnotes
This manuscript has recently been accepted for publication in the European Respiratory Journal. It is published here in its accepted form prior to copyediting and typesetting by our production team. After these production processes are complete and the authors have approved the resulting proofs, the article will move to the latest issue of the ERJ online. Please open or download the PDF to view this article.
Conflict of interest: Dr. Bajwah has nothing to disclose.
Conflict of interest: Dr. Davies has nothing to disclose.
Conflict of interest: Dr. Tanash has nothing to disclose.
Conflict of interest: Dr. Currow reports and 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: Dr. Oluyase has nothing to disclose.
Conflict of interest: Dr. Ekstrom has nothing to disclose.
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