PMID- 34193479
OWN - NLM
STAT- MEDLINE
DCOM- 20210803
LR  - 20220722
IS  - 2044-6055 (Electronic)
IS  - 2044-6055 (Linking)
VI  - 11
IP  - 6
DP  - 2021 Jun 30
TI  - Sex differences in type and occurrence of adverse reactions to opioid analgesics: 
      a retrospective cohort study.
PG  - e044157
LID - 10.1136/bmjopen-2020-044157 [doi]
LID - e044157
AB  - OBJECTIVES: Sex as a biological variable affects response to opioids. However, 
      few reports describe the prevalence of specific adverse reactions to commonly 
      prescribed opioids in men and women separately. A large cohort was used to 
      investigate sex differences in type and occurrence of adverse reactions 
      associated with use of codeine, tramadol, oxycodone and hydrocodone. DESIGN: 
      Retrospective cohort study. SETTING: Participants in the Right Drug, Right Dose, 
      Right Time (RIGHT) Study. PARTICIPANTS: The medical records of 8457 participants 
      in the RIGHT Study who received an opioid prescription between 1 January 2004 and 
      31 December 2017 were reviewed 61% women, 94% white, median age (Q1-Q3)=58 
      (47-66). PRIMARY AND SECONDARY OUTCOME MEASURES: Adverse reactions including 
      gastrointestinal, skin, psychiatric and nervous system issues were collected from 
      the allergy section of each patient's medical record. Sex differences in the risk 
      of adverse reactions due to prescribed opioids were modelled using logistic 
      regression adjusted for age, body mass index, race and ethnicity. RESULTS: From 
      8457 participants (of which 449 (5.3%) reported adverse reactions), more women 
      (6.5%) than men (3.4%) reported adverse reactions to at least one opioid (OR 
      (95% CI)=2.3 (1.8 to 2.8), p<0.001). Women were more likely to report adverse 
      reactions to tramadol (OR (95% CI)=2.8 (1.8 to 4.4), p<0.001) and oxycodone (OR 
      (95% CI)=2.2 (1.7 to 2.9), p<0.001). Women were more likely to report 
      gastrointestinal (OR (95% CI)=3.1 (2.3 to 4.3), p<0.001), skin (OR (95% CI)=2.1 
      (1.4 to 3.3), p=0.001) and nervous system issues (OR (95% CI)=2.3 (1.3 to 4.2), 
      p=0.004). CONCLUSIONS: These findings support the importance of sex as a 
      biological variable to be factored into pain management studies.
CI  - (c) Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No 
      commercial re-use. See rights and permissions. Published by BMJ.
FAU - Lopes, Guilherme S
AU  - Lopes GS
AUID- ORCID: 0000-0003-2923-2721
AD  - Department of Quantitative Health Sciences, Mayo Clinic, Rochester, Minnesota, 
      USA lopes.guilherme@mayo.edu.
FAU - Bielinski, Suzette
AU  - Bielinski S
AUID- ORCID: 0000-0002-2905-5430
AD  - Department of Quantitative Health Sciences, Mayo Clinic, Rochester, Minnesota, 
      USA.
FAU - Moyer, Ann M
AU  - Moyer AM
AD  - Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, 
      Minnesota, USA.
FAU - Jacobson, Debra J
AU  - Jacobson DJ
AD  - Department of Quantitative Health Sciences, Mayo Clinic, Rochester, Minnesota, 
      USA.
FAU - Wang, Liwei
AU  - Wang L
AD  - Department of Quantitative Health Sciences, Mayo Clinic, Rochester, Minnesota, 
      USA.
FAU - Jiang, Ruoxiang
AU  - Jiang R
AD  - Department of Quantitative Health Sciences, Mayo Clinic, Rochester, Minnesota, 
      USA.
FAU - Larson, Nicholas B
AU  - Larson NB
AD  - Department of Quantitative Health Sciences, Mayo Clinic, Rochester, Minnesota, 
      USA.
FAU - Miller, Virginia M
AU  - Miller VM
AD  - Department of Surgery and Department of Physiology and Biomedical Engineering, 
      Mayo Clinic, Rochester, Minnesota, USA.
FAU - Zhu, Ye
AU  - Zhu Y
AD  - Department of Quantitative Health Sciences, Mayo Clinic, Rochester, Minnesota, 
      USA.
FAU - Cavanaugh, Dana C
AU  - Cavanaugh DC
AD  - Department of Quantitative Health Sciences, Mayo Clinic, Rochester, Minnesota, 
      USA.
FAU - St Sauver, Jennifer
AU  - St Sauver J
AUID- ORCID: 0000-0002-9789-8544
AD  - Department of Quantitative Health Sciences, Mayo Clinic, Rochester, Minnesota, 
      USA.
LA  - eng
GR  - U19 GM061388/GM/NIGMS NIH HHS/United States
GR  - R01 AG034676/AG/NIA NIH HHS/United States
GR  - R01 GM028157/GM/NIGMS NIH HHS/United States
GR  - T32 HL007111/HL/NHLBI NIH HHS/United States
GR  - R33 AG058738/AG/NIA NIH HHS/United States
GR  - U54 AG044170/AG/NIA NIH HHS/United States
GR  - U01 HG005137/HG/NHGRI NIH HHS/United States
GR  - U01 HG006379/HG/NHGRI NIH HHS/United States
GR  - R01 GM125633/GM/NIGMS NIH HHS/United States
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
PT  - Research Support, Non-U.S. Gov't
DEP - 20210630
PL  - England
TA  - BMJ Open
JT  - BMJ open
JID - 101552874
RN  - 0 (Analgesics, Opioid)
RN  - CD35PMG570 (Oxycodone)
SB  - IM
MH  - *Analgesics, Opioid/adverse effects
MH  - Cohort Studies
MH  - Female
MH  - Humans
MH  - Male
MH  - Oxycodone/adverse effects
MH  - Retrospective Studies
MH  - *Sex Characteristics
PMC - PMC8246359
OTO - NOTNLM
OT  - ANAESTHETICS
OT  - Adverse events
OT  - EPIDEMIOLOGY
COIS- Competing interests: None declared.
EDAT- 2021/07/02 06:00
MHDA- 2021/08/04 06:00
PMCR- 2021/06/30
CRDT- 2021/07/01 06:13
PHST- 2021/07/01 06:13 [entrez]
PHST- 2021/07/02 06:00 [pubmed]
PHST- 2021/08/04 06:00 [medline]
PHST- 2021/06/30 00:00 [pmc-release]
AID - bmjopen-2020-044157 [pii]
AID - 10.1136/bmjopen-2020-044157 [doi]
PST - epublish
SO  - BMJ Open. 2021 Jun 30;11(6):e044157. doi: 10.1136/bmjopen-2020-044157.