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Review: Opioids Reduce Breathlessness in COPD

Review of 16 studies shows no effect on exercise capacity; no adverse effects reported

FRIDAY, April 3, 2015 (HealthDay News) — In chronic obstructive pulmonary disease (COPD), opioids can improve breathlessness, but not exercise capacity, according to a review published online March 24 in the Annals of the American Thoracic Society.

Magnus Ekström, M.D., Ph.D., from Lund University in Sweden, and colleagues examined the efficacy and safety of opioids on refractory breathlessness, exercise capacity, and health-related quality of life in COPD. Data were included from 16 studies (15 crossover trials and one parallel group study), including 271 participants (95 percent with severe COPD).

The researchers found that there were no reports of serious adverse effects. Reductions in breathlessness were seen with opioids overall (standardized mean difference [SMD], −0.35), systemic opioids (SMD, −0.34), and, less consistently, with nebulized opioids (SMD, −0.39). According to GRADE, the quality of evidence was moderate for systemic opioids and low for nebulized opioids. Opioids had no impact on exercise capacity (SMD, 0.06). In sensitivity analyses, findings were robust.

“In severe COPD, low-dose opioids reduced breathlessness, with the strongest evidence for systemic therapy, whereas exercise capacity was not affected,” the authors write.

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