Gabapentin and Pregabalin and Risk of Atrial Fibrillation in the Elderly: A Population-Based Cohort Study in an Electronic Prescription Database
| Autor: | Ortiz de Landaluce, Leticia, Carbonell, Pere, Asensio, Carmen, Escoda, Núria, López, Pilar, Laporte Rosselló, Joan-Ramón, Universitat Autònoma de Barcelona |
|---|---|
| Přispěvatelé: | [Ortiz-de-Landaluce L, Carbonell P, Escoda N, López P] Gerència de Prestacions Farmacèutiques i Accés al Medicament, Servei Català de la Salut, Departament de Salut, Barcelona, Spain. [Asensio C, Laporte JR] Fundació Institut Català de Farmacologia (FICF), Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain, Departament de Salut |
| Předmět: |
Male
Databases Factual Epidemiology Pregabalin Organic Chemicals::Amines::Gabapentin [CHEMICALS AND DRUGS] 030204 cardiovascular system & hematology Toxicology Otros calificadores::Otros calificadores::/efectos adversos [Otros calificadores] Cohort Studies Electronic Prescribing 0302 clinical medicine Risk Factors Atrial Fibrillation Diagnosis Pharmacology (medical) Original Research Article 030212 general & internal medicine Electronic prescribing education.field_of_study Analgesics Organic Chemicals::Carboxylic Acids::Acids Acyclic::Butyrates::Aminobutyrates::gamma-Aminobutyric Acid::Pregabalin [CHEMICALS AND DRUGS] Age Factors enfermedades cardiovasculares::enfermedades cardíacas::arritmias cardíacas::fibrilación atrial [ENFERMEDADES] Alprazolam Population Surveillance Persons::Age Groups::Adult::Aged [NAMED GROUPS] Cohort studies Female Gabapentin Age factors medicine.drug medicine.medical_specialty Analgesic Population Sistema cardiovascular - Malalties en les persones grans 03 medical and health sciences Internal medicine medicine Other subheadings::Other subheadings::/adverse effects [Other subheadings] Humans Adverse effect education Fibril·lació auricular - Prevenció personas::Grupos de Edad::adulto::anciano [DENOMINACIONES DE GRUPOS] Retrospective Studies Aged Pharmacology business.industry Adverse effects Medicaments - Efectes secundaris Retrospective cohort study Atrial fibrillation Retrospective studies Risk factors Relative risk compuestos orgánicos::ácidos carboxílicos::ácidos acíclicos::butiratos::aminobutiratos::ácido gamma-aminobutírico::pregabalina [COMPUESTOS QUÍMICOS Y DROGAS] business Cardiovascular Diseases::Heart Diseases::Arrhythmias Cardiac::Atrial Fibrillation [DISEASES] |
| Zdroj: | Scientia Recercat. Dipósit de la Recerca de Catalunya instname Dipòsit Digital de Documents de la UAB Universitat Autònoma de Barcelona Recercat: Dipósit de la Recerca de Catalunya Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya) Drug Safety |
| Popis: | Altres ajuts: This work is part of a project on safety of electronic prescribing of the Catalan Health Service and Fundació Institut Català de Farmacologia. Gabapentin and pregabalin are widely prescribed to elderly people, but data on their pharmacokinetics, safety, and efficacy in this population are scarce. Neurological adverse effects are common. Atrial fibrillation (AF) associated with their use has been described in several case reports and case series, but the incidence is unknown. The aim of this study was to assess the association between exposure to gabapentin or pregabalin and AF in the elderly. Patients ≥ 65 years of age starting treatment with either gabapentin or pregabalin between January 1 and March 31, 2015, free of cardiovascular disease, and who did not receive the alternate study medications were studied. They were compared with patients who initiated treatment with an analgesic opiate or with alprazolam or diazepam. The two primary outcome variables were a first claim of an oral anticoagulant plus an antiarrhythmic drug (OAC + AA), or of an oral anticoagulant or an antiplatelet agent plus an antiarrhythmic drug (OAC/APA + AA), in the 3 months after treatment initiation. Compared with opiate analgesics, both gabapentin and pregabalin were associated with an increased risk of initiating OAC/APA + AA. The incidence was 6 of 668 (9.0 per 1000 patients) with gabapentin, versus 12 of 3889 (3.1 per 1000) with opiates, relative risk (RR) 2.91 (95% confidence interval [CI] 1.10-7.73), and for pregabalin it was 6 of 698 (8.6 per 1000) RR 2.79 (95% CI 1.05-7.40). The comparison with alprazolam/diazepam gave similar results. The risks did not vary by age, sex, or co-treatment with NSAIDs, and they increased with dose. In elderly patients free of cardiovascular disease, an association between new exposure to gabapentin or pregabalin and initiating treatment for AF was found. These results should be confirmed in other studies. The online version of this article (10.1007/s40264-018-0695-6) contains supplementary material, which is available to authorized users. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|