Opioid Prescription Heightens Pneumonia Risk

Researchers have found a link between prescribed opioids—particularly higher dose and immunosuppressive opioids—and increased likelihood of community-acquired pneumonia (CAP), regardless of HIV status.

From March 15, 2017, through Aug. 8, 2018, researchers queried the Veterans Aging Cohort Study (VACS) for data spanning Jan. 1, 2000–Dec. 31, 2012. VACS participants hospitalized for CAP (n = 4,246) were matched 1:5 to non-CAP patients (n = 21,146) based on age, sex, race, length of observation, and HIV status. Researchers stratified prescribed opioid use during the 12-month period prior to the index date by timing (none, past, or current); low (<20 mg), medium (20–50 mg), or high (>50 mg) median morphine equivalent daily dose; and the prescription’s opioid immunosuppressive properties (yes vs. unknown or no).

Higher opioid dose tied to increased risk for community-acquired pneumonia, study indicates. https://t.co/NbAze3nbPZ

— CHEST (@accpchest) January 10, 2019

Prescribed #opioids increase risk for #pneumonia https://t.co/xYGMWWsSLq

— Dr. Richard Saitz (@UnhealthyAlcDrg) January 7, 2019

Nearly all (98.9%) of the 25,392 total VACS participants were male; mean age of the total cohort was 55 years. Patients with a current medium opioid dose with unknown or no immunosuppressive (adjusted odds ratio [AOR], 1.35; 95% CI, 1.13-1.62) and immunosuppressive properties (AOR, 2.07; 95% CI, 1.50-2.86), and a current high dose of opioids with unknown or no immunosuppressive (AOR, 2.07; 95% CI, 1.50-2.86) and immunosuppressive properties (AOR, 3.18; 95% CI, 2.44-4.14), had the highest risk of CAP when compared to patients without a current or past opioid prescription for medication with no immunosuppressive (AOR, 1.24; 95% CI, 1.09-1.40) and immunosuppressive properties (AOR, 1.42; 95% CI, 1.21-1.67). Patients with HIV had a greater CAP risk if they had a current opioid prescription, and the risk was greater among immunosuppressive opioid prescription recipients (AORs for current immunosuppressive opioids with medium dose, 1.76 [95% CI, 1.20-2.57] vs 2.33 [95% CI, 1.60-3.40]).

https://twitter.com/DrJackieVolk/status/1082411605277724679

Nice paper from @YaleMed investigators: opioids independently contribute to community-acquired pneumonia risk among patients living with and without HIV; https://t.co/6epeQAgpN9

— Joseph Ross (@jsross119) January 7, 2019

The findings were published in JAMA Internal Medicine.

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Source: JAMA Internal Medicine