B オピオイド使用で有害事象が増える：Study Shows Higher Risks for Opioid Pain Drugs - WSJ.com

リンク: Study Shows Higher Risks for Opioid Pain Drugs - WSJ.com.

関節炎の痛みを緩和するために安易にオピオイドを使うと，かえって有害事象が増大するという記事です。米国と異なり日本では，それほど簡単にオピオイドは使われていません。

Arthritis patients taking opioid pain drugs had a higher risk of bone fractures and death compared with people taking other painkillers, according to a study that looked at Medicare claims records.

Researchers from Harvard-affiliate Brigham and Women's Hospital in Boston looked at painkiller use among Medicare beneficiaries over seven years, and found elevated risks from opioids, compared with other painkilling medications.

Other pain drugs compared included older ones like ibuprofen, Advil and Motril known as nonsteroidal anti-inflammatory drugs, or NSAIDs. Also compared were newer pain drugs, called "coxibs," like Celebrex and Vioxx, which has been withdrawn from the market.

Researchers focused on opioids because they have garnered relatively limited attention during the focus on other painkillers in recent years.

The study found that opioids were linked to an 87% increased risk of death during the study, compared to NSAIDs like ibuprofen. The coxib drugs didn't raise the risk of death. The study focused on 12,840 patients in Pennsylvania and New Jersey treated between January 1999 and December 2005.

The opioid drugs were linked to a 68% increase in overall "safety events"—ranging from intestinal bleeding to stroke and heart attack to fractures—when compared with the older painkillers. Newer pain drugs didn't show any increase in these overall safety events.

Perhaps most striking, the opioids were linked to a risk of fractures that was 4.5 times that in patients taking the NSAID drugs. Opioids include codeine, hydrocodone, oxycodone, propoxyphene and tramadol. But the risks weren't consistent among these. A second study by the same researchers found that the risk of death from any cause was 2.4 times as likely among those taking oxycodone, and twice as likely with those taking codeine, compared to those taking hydrocodone. Both studies are published in Monday's Archives of Internal Medicine.

Researchers noted that while the records examined showed "strong associations" between certain drugs and safety events, such an analysis of Medicare claims records "cannot prove causation."