关于慢性肾病 (CKD) 患者使用羟考酮与急性呼吸系统疾病之间关系的数据很少。本研究的目的是调查与其他阿片类药物相比，羟考酮是否与癌症和 CKD 患者急性呼吸系统疾病的风险增加有关。数据来自日本的索赔数据库。选择2014年4月至2021年5月期间接受缓释阿片类药物（包括口服羟考酮、口服吗啡或透皮芬太尼）的癌症和慢性肾病患者。主要结局被定义为急性呼吸系统疾病。将年龄和性别、吗啡每日当量剂量、特定药物的同时使用、基于改良查尔森合并症指数定义的合并症、物质使用障碍以及肺癌或转移性肺癌的数据作为协变量进行研究。使用对数秩检验比较三个缓释阿片类药物组之间的急性呼吸系统疾病的分布。使用具有时变变量的Cox比例风险模型比较各组之间急性呼吸系统疾病发生率的估计。发现三组之间急性呼吸系统疾病的分布存在显着差异（P<0.01）。 Cox 回归分析显示，与羟考酮相比，吗啡引起急性呼吸系统疾病的风险显着较高（风险比 [HR]：3.04，95% 置信区间 [CI]：1.07-8.65，P=0.04），但与羟考酮的风险无显着差异与芬太尼相比（HR 0.67，95% CI 0.32-1.38，P=0.27）。研究结果表明，使用羟考酮治疗癌痛的 CKD 患者发生急性呼吸系统疾病的风险可能低于使用吗啡的患者。此外，使用羟考酮和芬太尼之间没有发现急性呼吸道疾病的风险存在差异。本文受版权保护。版权所有。

Few data are available on the association between use of oxycodone in patients with chronic kidney disease (CKD) and acute respiratory conditions. The aim of this study was to investigate whether oxycodone is associated with an increased risk of acute respiratory conditions in patients with cancer and CKD compared with other opioids.The data were obtained from a claims database in Japan. Patients with cancer and CKD who had received sustained-release opioids, including oral oxycodone, oral morphine, or transdermal fentanyl, between April 2014 and May 2021 were selected. The primary outcome was defined as an acute respiratory condition. Data for age and sex, morphine equivalent daily dose, concomitant use of specified medications, comorbidities defined based on the modified Charlson comorbidity index, substance use disorder, and lung cancer or metastatic lung cancer were investigated as covariates. Distribution of acute respiratory conditions was compared among the three sustained-release opioid groups using the log-rank test. Estimates of the incidence of acute respiratory conditions were compared among the groups using a Cox proportional hazards model with time-varying variables.A significant difference in the distribution of acute respiratory conditions was found among the three groups (P<0.01). Cox regression analysis showed a significantly higher risk of acute respiratory conditions with morphine (hazard ratio [HR]: 3.04, 95% confidence interval [CI]: 1.07-8.65, P=0.04) compared with oxycodone but no significant difference in risk with oxycodone (HR 0.67, 95% CI 0.32-1.38, P=0.27) compared with fentanyl.The findings suggest that the risk of acute respiratory conditions may be lower in patients with CKD who use oxycodone for cancer pain than in those who use morphine. Additionally, no difference in the risk of acute respiratory conditions was found between oxycodone and fentanyl use.This article is protected by copyright. All rights reserved.