New cannabinoid use may elevate risk for adverse outcomes in older adults with COPD
Older adults with COPD who were new users of oral cannabinoids had increased risk for all-cause mortality and those using higher doses had increased risk for hospitalization for COPD or pneumonia, according to data published in Thorax.
“Older adults with COPD represent a group that would likely be more susceptible to cannabinoid-related respiratory side effects since older adults less efficiently break down drugs and, hence, drug effects can linger in the body for longer,” Nicholas T. Vozoris, MD, FRCPC, MHSc, assistant professor and clinical investigator in the department of medicine at the University of Toronto, respirologist at St. Michael’s Hospital and associate scientist at Li Ka Shing Knowledge Institute, Ontario, said in a press release. “And individuals with COPD have pre-existing respiratory troubles and respiratory compromise.”
Researchers conducted a retrospective, population-based, data-linkage cohort study to investigate health data on 2,106 individuals with COPD aged 66 years and older in Ontario, Canada, who recently received a cannabinoid drug. The researchers identified an additional 2,106 individuals who were new users of a non-cannabinoid drug as the control group.
The hospitalization rate for COPD or pneumonia was not significantly different between new cannabinoid users and the control group (HR = 0.87; 95% CI, 0.61-1.24).
However, researchers observed significantly higher rates of all-cause mortality among new cannabinoid users compared with the control group (HR = 1.64; 95% CI, 1.14-2.39; P = .01).
Those using higher-dose cannabinoids had a 178% relative increase in hospitalization for COPD or pneumonia (HR = 2.78; 95% CI, 1.17-7.09; P = .06) and a 231% relative increase in all-cause mortality (HR = 3.31; 95% CI, 1.30-9.51; P = .04) compared with the control group.
The researchers also conducted a subanalysis to investigate the impact of cannabinoid use compared with opioid drugs on respiratory outcomes in older adults with COPD and found no evidence supporting cannabinoids as a safer choice over opioids.
“Our study results do not mean that cannabinoid drugs should be never used among older adults with COPD. Rather, our findings should be incorporated by patients and physicians into prescribing decision-making,” Vozoris said in the release. “Our results also highlight the importance of favoring lower over higher cannabinoid doses when these drugs actually do need to be used.”