Thorax

Do gabapentinoids pose a greater asthma risk than other chronic pain therapies?

September 24, 2025

Study details: This nationwide retrospective cohort study used administrative claims data to compare asthma exacerbation risk in patients with asthma and chronic or neuropathic pain initiating gabapentinoids vs. tricyclic antidepressants (TCAs) or serotonin-norepinephrine reuptake inhibitors (SNRIs). Overlap propensity score weighting was used to control for confounders. Primary outcome: asthma exacerbation requiring systemic corticosteroids; secondary outcome: exacerbation requiring hospitalization.

Results: Gabapentinoid use was associated with a higher incidence of asthma exacerbations compared with both TCAs and SNRIs:

• Gabapentinoids vs. TCAs
  Exacerbations: 59.4 vs. 33.7 per 100 person-years; hazard ratio [HR] 1.46; 95% confidence interval [CI], 1.34–1.60Hospitalizations: 0.91 vs. 0.42 per 100 person-years; HR: 2.02; 95% CI, 1.11–3.68
• Gabapentinoids vs. SNRIs
  Exacerbations: 63.5 vs. 42.8 per 100 person-years; HR: 1.24; 95% CI, 1.19–1.30Hospitalizations: 0.93 vs. 0.68 per 100 person-years; HR: 1.24; 95% CI, 0.94–1.63; not statistically significant

Clinical impact: Gabapentinoids are associated with a clinically meaningful increase in asthma exacerbation risk compared with alternative chronic pain agents. Clinicians should exercise caution when prescribing gabapentinoids to patients with asthma and consider TCAs or SNRIs when appropriate.

Source:

Kimura Y, et al. (2025, August 24). Thorax. Gabapentinoids and risk for asthma exacerbations: a nationwide retrospective cohort study. https://pubmed.ncbi.nlm.nih.gov/40850791/