Adverse Outcomes Associated With Off-Label Agents Used to Treat Dementia Patients With Psychosis: A Case-Control Medicare Database Study.

IF 4.7 Q2 MATERIALS SCIENCE, BIOMATERIALS ACS Applied Bio Materials Pub Date : 2022-01-01 DOI:10.1177/15333175221081374

Nazia Rashid, James B Wetmore, Muna Irfan, Victor Abler

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Abstract

Introduction: Currently, there are no Food and Drug Administration-approved therapies to treat dementia-related psychosis (DRP). This study investigated the association between using antipsychotics and the anticonvulsant divalproex (sodium valproate) to manage DRP and adverse outcomes.

Methods: A retrospective case/control matching study evaluated the risk of mortality, extrapyramidal symptoms (EPS), ischemic stroke, and cardiac arrest/ventricular arrhythmia (CA/VA) with ever-use of antipsychotics/divalproex in patients with DRP vs never-use.

Results: 49 509 patients were included; 76.8% used an antipsychotic/divalproex. Treatment ever-use was associated with an increased risk of all-cause mortality (odds ratio, 1.14; 95% CI, 1.10-1.18) and a smaller increase in the risk of EPS (1.10; 1.00-1.19) relative to never-use (adjusted for matching demographic variables, comorbid conditions, and disability).

Conclusions: Current agents used for DRP were associated with increased risk of death and adverse outcomes. An increased risk of death was evident within 3 months of antipsychotic/divalproex initiation and persisted with long-term use.

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用于治疗老年痴呆症患者的标示外药物的不良后果：病例对照医疗保险数据库研究》。

简介：目前，美国食品和药物管理局尚未批准治疗痴呆相关精神病（DRP）的疗法。本研究调查了使用抗精神病药物和抗惊厥药物丙戊酸钠（divalproex）治疗痴呆相关精神病与不良后果之间的关系：一项回顾性病例/对照配对研究评估了DRP患者曾经使用抗精神病药物/双丙戊酸钠与从未使用的死亡率、锥体外系症状（EPS）、缺血性中风和心脏骤停/室性心律失常（CA/VA）的风险：共纳入49 509名患者，其中76.8%使用过抗精神病药/特戊普乐。与从未使用抗精神病药物相比，曾经使用抗精神病药物与全因死亡风险增加有关（几率比为 1.14；95% CI，1.10-1.18），而 EPS 风险增加较小（1.10；1.00-1.19）（已对匹配的人口统计学变量、合并症和残疾情况进行调整）：结论：目前用于DRP的药物与死亡风险和不良后果的增加有关。死亡风险的增加在开始使用抗精神病药/双丙戊酸钠的3个月内显而易见，并在长期使用后持续存在。

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来源期刊

ACS Applied Bio Materials Chemistry-Chemistry (all)

CiteScore

9.40

自引率

2.10%

发文量

464

期刊介绍： ACS Applied Bio Materials is an interdisciplinary journal publishing original research covering all aspects of biomaterials and biointerfaces including and beyond the traditional biosensing, biomedical and therapeutic applications. The journal is devoted to reports of new and original experimental and theoretical research of an applied nature that integrates knowledge in the areas of materials, engineering, physics, bioscience, and chemistry into important bio applications. The journal is specifically interested in work that addresses the relationship between structure and function and assesses the stability and degradation of materials under relevant environmental and biological conditions.