HealthDay News — Opioids can improve breathlessness, but not exercise capacity, in patients with chronic obstructive pulmonary disease, results of a review published in the Annals of the American Thoracic Society suggest.

To examine the efficacy and safety of opioids on refractory breathlessness, exercise capacity, and health-related quality of life in patients with chronic obstructive pulmonary disease (COPD), Magnus Ekström, MD, PhD, of Lund University in Sweden, and colleagues reviewed data from 16 studies (15 crossover trials and one parallel group study).

There were no reports of serious adverse effects among the 271 patients (95% with severe COPD), reported the investigators. Reductions in breathlessness were seen with opioids overall (standardized mean difference [SMD], −0.35), systemic opioids (SMD, −0.34), and, less consistently, with nebulized opioids (SMD, −0.39).

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According to GRADE, the quality of evidence was moderate for systemic opioids and low for nebulized opioids. Opioids had no impact on exercise capacity (SMD, 0.06). In sensitivity analyses, findings were robust.

“In severe COPD, low-dose opioids reduced breathlessness, with the strongest evidence for systemic therapy, whereas exercise capacity was not affected,” concluded the researchers.


  1. Ekström M et al. Annals of the American Thoracic Society. 2015; doi: 10.1513/AnnalsATS.201501-034OC