Cardiovascular Safety of Metoclopramide Compared to Domperidone: A Population-Based Cohort Study
Autor: | Flory Muanda Tsobo, Andrea Cowan, Matthew A. Weir, Eric McArthur, Amit X. Garg |
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Rok vydání: | 2020 |
Předmět: |
medicine.medical_specialty
Gastroparesis Metoclopramide Prokinetic Population 030204 cardiovascular system & hematology 03 medical and health sciences 0302 clinical medicine Internal medicine medicine 030212 general & internal medicine education AcademicSubjects/MED00260 education.field_of_study business.industry Original Articles medicine.disease Confidence interval 3. Good health Domperidone Relative risk Propensity score matching Cohort Cardiovascular death business medicine.drug |
Zdroj: | Journal of the Canadian Association of Gastroenterology |
ISSN: | 2515-2092 |
Popis: | Background Metoclopramide and domperidone are common prokinetics used to alleviate gastrointestinal symptoms. However, both drugs may trigger ventricular arrhythmias. Aim We conducted this population-based study to compare the 30-day cardiovascular safety of metoclopramide versus domperidone in outpatient care. Methods We used health care databases to identify a cohort of patients in Ontario, Canada newly dispensed metoclopramide or domperidone. Inverse probability of treatment weighting based on propensity scores was used to balance the baseline characteristics of the two groups. All outcomes were assessed in the 30 days following drug dispensing. The primary outcome was hospital encounter with ventricular arrhythmia. The secondary outcomes were hospital encounter with cardiac arrest, all-cause mortality and cardiovascular mortality. Results We identified 196,544 patients, 19% of whom were prescribed metoclopramide. There was no difference in the risk of a hospital encounter with ventricular arrythmia (0.02% in both groups), or cardiac arrest (0.10% with metoclopramide and 0.08% with domperidone). However, 1.34% of patients died after starting metoclopramide compared to 0.52% of patients starting domperidone; weighted risk ratio 2.50 (95% confidence interval [CI] 2.13 to 3.03). Similarly, 0.42% of patients died of cardiovascular causes after starting metoclopramide compared to 0.19 % of patients starting domperidone; weighted risk ratio 2.00 (95% CI 1.44 to 2.77). Conclusion The 30-day risk for a hospital encounter with ventricular arrhythmia was low for both metoclopramide and domperidone, with no significant difference in the rate between the two drugs. The higher 30-day risk of death observed with metoclopramide compared with domperidone in this study has also been observed in other studies and warrants further investigation. |
Databáze: | OpenAIRE |
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