Department of Psychiatry, The Seventh Hospital of Hangzhou, Hangzhou, China.
Int J Geriatr Psychiatry. 2019 Apr;34(4):513-521. doi: 10.1002/gps.5048. Epub 2019 Jan 8.
Benzodiazepines and benzodiazepine-related drugs (BZRDs) are used to treat various psychiatric diseases. However, there are concerns that BZRDs increase the risk of pneumonia.
We performed a systematic review and meta-analysis of observational studies to determine whether BZRD use affects the risk of pneumonia. Our analysis included all observational studies that compared pneumonia development among patients receiving BZRD vs those with no treatment.
In total, 12 citations of 10 studies involving more than 120,000 pneumonia cases were included in our meta-analysis. After pooling the estimates, the odds for developing pneumonia were 1.25-fold higher (odd ratio, OR = 1.25; 95% confidence interval (CI), 1.09-1.44) in BZRD users compared with individuals who had not taken BZRD. On the basis of exposure window, we found an increased risk of pneumonia among current (OR = 1.4; 95%CI, 1.22-1.6) and recent (OR = 1.38; 95%CI, 1.06-1.8) users, but not with the past users (OR = 1.11; 95%CI, 0.96-1.27).
Current or recent exposure to BZRD is associated with an increased pneumonia risk. Clinicians need to weight the benefit-risk balance of BZRD use, especially those with other risk factors for pneumonia.
苯二氮䓬类药物和苯二氮䓬类相关药物(BZRDs)用于治疗各种精神疾病。然而,人们担心 BZRDs 会增加肺炎的风险。
我们对观察性研究进行了系统评价和荟萃分析,以确定 BZRD 使用是否会影响肺炎的风险。我们的分析包括所有比较接受 BZRD 治疗和未接受治疗的患者中肺炎发展情况的观察性研究。
共有 10 项研究的 12 项引用纳入了我们的荟萃分析,涉及超过 120000 例肺炎病例。汇总估计后,与未使用 BZRD 的患者相比,BZRD 使用者发生肺炎的几率高 1.25 倍(比值比,OR=1.25;95%置信区间,CI:1.09-1.44)。基于暴露窗口,我们发现当前(OR=1.4;95%CI:1.22-1.6)和近期(OR=1.38;95%CI:1.06-1.8)使用者肺炎风险增加,但过去使用者(OR=1.11;95%CI:0.96-1.27)则不然。
目前或近期接触 BZRD 与肺炎风险增加相关。临床医生需要权衡 BZRD 使用的获益风险平衡,尤其是那些有其他肺炎风险因素的患者。