Odds of Death Up With Exposure to Pregabalin, Opioids

Dose-response association with highest odds of opioid-related death with high-dose prefabbing.
Dose-response association with highest odds of opioid-related death with high-dose prefabbing.

HealthDay News — Concomitant exposure to pregabalin and opioids is associated with increased odds of opioid-related death, according to a research letter published online Aug. 21 in the Annals of Internal Medicine.

Tara Gomes, PhD, from the University of Toronto, and colleagues conducted a population-based nested case-control study and identified a cohort of persons aged 15 to 105 years who received publicly funded opioid prescriptions between August 1, 1997, and December 31, 2016. Case patients (1417), defined as those who died of an opioid-related cause, were matched with up to four controls based on age, sex, index year, history of chronic kidney disease, and Charlson comorbidity index (5,097 participants). 

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The researchers found that, compared with opioid exposure alone, concomitant exposure to pregabalin in the preceding 120 days correlated with significantly elevated odds of opioid-related deaths (adjusted odds ratio, 1.68). Results were consistent in sensitivity analyses assessing pregabalin use overlapping the index date and after matching on prior use of central nervous system depressants (odds ratios, 1.81 and 2.00, respectively). A high dose of pregabalin correlated with increased odds of opioid-related death compared to no pregabalin exposure in the dose-response analysis (adjusted odds ratio, 2.51), while the odds of opioid-related death were lower but still significantly elevated with a low or moderate dose of pregabalin (adjusted odds ratio, 1.52).

"The importance of our finding warrants a revision of the pregabalin product monographs," the authors write.

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