Escorial Mónica, Muriel Javier, Margarit César, Agulló Laura, Morales Domingo, Peiró Peiró Ana M
Neuropharmacology Applied to Pain (NED), Alicante Institute for Health and Biomedical Research (ISABIAL), c/Pintor Baeza, 12, 03010 Alicante, Spain.
Institute of Bioengineering, Miguel Hernández University, Avda. de la Universidad s/n, 03202 Elche, Spain.
Biomedicines. 2022 Sep 16;10(9):2302. doi: 10.3390/biomedicines10092302.
(1) Background: It is essential to focus attention on sex-specific factors which are clinically relevant in pain management, especially with regards to opioid use disorder (OUD) risk. The aim of this study was to explore potential sex-differences in chronic non-cancer pain (CNCP) outpatients. (2) Methods: An observational cross-sectional study was conducted under CNCP outpatients with long-term prescribed opioids ( = 806), wherein 137 patients had an OUD diagnosis (cases, 64% females) and 669 did not (controls, 66% females). Socio-demographic, clinical, and pharmacological outcomes were analyzed. (3) Results: Female controls presented an older age and less intensive pain therapy but higher psychotropic prescriptions and emergency department visits compared to male controls. Meanwhile, cases demonstrated a younger age, higher work disability, double morphine equivalent daily dose, and benzodiazepine use compared with controls. Here, female cases showed an 8% greater substance use disorder (OR 2.04 [1.11-3.76]) and 24% lower tramadol use, while male cases presented a 22% higher fentanyl use (OR 2.97 [1.52-5.81]) and reported the highest number of adverse drug reactions (24%, OR 2.40 [1.12-5.16]) compared with controls. (4) Conclusions: An OUD individual risk profile was evidenced with sex-differences to take into consideration to design equal prevention programs.
(1) 背景：关注疼痛管理中具有临床相关性的性别特异性因素至关重要，尤其是在阿片类药物使用障碍（OUD）风险方面。本研究的目的是探讨慢性非癌性疼痛（CNCP）门诊患者中潜在的性别差异。(2) 方法：对长期开具阿片类药物的CNCP门诊患者（n = 806）进行了一项观察性横断面研究，其中137例患者被诊断为OUD（病例组，64%为女性），669例未被诊断为OUD（对照组，66%为女性）。分析了社会人口统计学、临床和药理学结果。(3) 结果：与男性对照组相比，女性对照组年龄更大，疼痛治疗强度更低，但精神药物处方和急诊就诊次数更高。同时，与对照组相比，病例组年龄更小，工作残疾率更高，每日吗啡当量剂量翻倍，且使用苯二氮䓬类药物。在此，女性病例的物质使用障碍发生率高出8%（OR 2.04 [1.11 - 3.76]），曲马多使用率低24%，而男性病例的芬太尼使用率高出22%（OR 2.97 [1.52 - 5.81]），且报告的药物不良反应发生率最高（24%，OR 2.40 [1.12 - 5.16]）。(4) 结论：证实了OUD个体风险特征存在性别差异，在设计平等的预防方案时应予以考虑。
