Clinical outcomes associated with antidepressant use in inflammatory bowel disease patients and a matched control cohort.

Autor: Ba DM; Department of Public Health Sciences, Pennsylvania State University College of Medicine, Hershey, PA, USA.; Center for Applied Studies in Health Economics (CASHE), Pennsylvania State University College of Medicine, Hershey, PA, USA., Yadav S; Department of Psychiatry, Pennsylvania State University College of Medicine, Hershey, PA, USA., Liu G; Department of Public Health Sciences, Pennsylvania State University College of Medicine, Hershey, PA, USA.; Center for Applied Studies in Health Economics (CASHE), Pennsylvania State University College of Medicine, Hershey, PA, USA., Leslie DL; Department of Public Health Sciences, Pennsylvania State University College of Medicine, Hershey, PA, USA.; Center for Applied Studies in Health Economics (CASHE), Pennsylvania State University College of Medicine, Hershey, PA, USA., Vrana KE; Department of Pharmacology, Pennsylvania State University College of Medicine, Hershey, PA, USA., Coates MD; Department of Pharmacology, Pennsylvania State University College of Medicine, Hershey, PA, USA. mcoates@pennstatehealth.psu.edu.; Department of Medicine, Division of Gastroenterology and Hepatology, Pennsylvania State University College of Medicine, Hershey, PA, USA. mcoates@pennstatehealth.psu.edu.; Penn State-Hershey Medical Center, 500 University Dr., Hershey, PA, 17033, USA. mcoates@pennstatehealth.psu.edu.
Jazyk: angličtina
Zdroj: Scientific reports [Sci Rep] 2024 Jan 11; Vol. 14 (1), pp. 1060. Date of Electronic Publication: 2024 Jan 11.
DOI: 10.1038/s41598-024-51282-6
Abstrakt: Antidepressant medications (AMs) are frequently used in inflammatory bowel disease (IBD). Many AMs enhance serotonin (5-HT) availability, but this phenomenon may actually worsen IBD. We hypothesized that use of 5-HT-enhancing AMs would be associated with poor clinical outcomes in these disorders. We performed a retrospective cohort study using the Merative Health Marketscan® commercial claims database between 1/1/05 and 12/31/14. Participants (18-63 years) were either controls or had ≥ 2 ICD-9 diagnoses for IBD with ≥ 1 year of continuous insurance enrollment before index diagnosis and 2 years after. We identified new AM prescriptions using the medication possession ratio. Primary outcomes were corticosteroid use (IBD-only), IBD-related complication (IBD-only), IBD-related surgery (IBD-only), hospitalization, and emergency department (ED) visit(s) within 2 years of diagnosis or starting AM. We calculated adjusted hazard ratios (aHRs) in IBD AM users (for each outcome). We also performed subgroup analyses considering IBD and AM subtype. In the IBD cohort (n = 29,393, 41.4% female; 42.2%CD), 5.2% used AMs. In IBD, AM use was independently associated with corticosteroid use, ED visits, and hospitalizations, but not IBD-related complications. AM use was associated with a decreased risk of surgery. In the control cohort (n = 29,393, 41.4% female), AM use was also independently associated with ED visits and hospitalizations, and there was an increased likelihood of these two outcomes compared to the IBD cohort. In conclusion, while AM use was independently associated with an increased risk of ED visits and hospitalization in IBD, these risks were statistically more common in a matched control cohort. Additionally, AM use was associated with reduced risk of surgery in IBD, demonstrating a potential protective role in this setting.
(© 2024. The Author(s).)
Databáze: MEDLINE
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