Antipsychotic drug exposure and risk of pneumonia: a systematic review and meta-analysis of observational studies
Antipsychotic drug exposure and risk of pneumonia: a systematic review and meta-analysis of observational studies
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DOI：
10.1002/pds.3804
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发表时间：
2015-08-01
影响因子：
2.6
通讯作者：
Barbui, Corrado
中科院分区：
文献类型：
--
作者：
Nose, Michela;Recla, Elisabetta;Barbui, Corrado
目的肺炎是65岁以上人群发病和死亡的主要原因之一。最近，一些研究表明，抗精神病药（AP）的使用和老年患者肺炎的风险之间存在关联。本系统综述和观察性研究荟萃分析的目的是调查第一代和第二代AP药物是否会增加老年人和年轻人群的肺炎风险，并确定与暴露于个别药物相关的风险。系统性综述和Meta分析中纳入了对照研究，这些研究报告了暴露于AP药物的个体与未暴露于AP药物或既往暴露于AP药物的个体相比的肺炎结局数据。分析.研究参与者不分性别和年龄，在诊断类别方面没有限制。结果暴露于第一代AP药物显著增加了肺炎的风险（比值比（OR）1.68，95%置信区间（95%CI）1.39-2.04，I-2=47%）和暴露于第二代AP药物（OR 1.98，95%CI 1.67-2.35，I-2=36.7%）。不同诊断类别和年龄组之间的风险相似，在老年人和成年人人群中;年龄的发现得到了荟萃回归分析的证实，该分析未检测到年龄与肺炎风险之间的任何关系。只有少数研究提供的数据对个别drugs.ConclusionSystematic审查目前的观察证据表明，暴露于第一代和第二代AP药物与肺炎的风险增加。本系统性综述扩展了先前的知识，表明风险增加不仅适用于老年人，也适用于年轻患者。关于单个化合物的肺炎风险的信息仍然非常有限。版权所有（c）2015约翰威利父子有限公司
PurposePneumonia is one of the major leading causes of morbidity and mortality among persons aged 65years or older. Recently, several studies suggested an association between antipsychotic (AP) use and risk of pneumonia in elderly patients. The aim of the present systematic review and meta-analysis of observational studies was to investigate if first-generation and second-generation AP drugs increase the risk of pneumonia in the elderly and also in the younger population, and to ascertain the risk associated with exposure to individual drugs.MethodsAll observational cohort or case-control studies that reported data on pneumonia outcomes in individuals exposed to AP drugs as compared with individuals unexposed or with past exposure to AP drugs were included in the systematic review and meta-analysis. Study participants were of either sex and of any age with no restrictions in terms of diagnostic categories.ResultsThe risk of pneumonia was significantly increased by exposure to first-generation AP drugs (odds ratio (OR) 1.68, 95% confidence interval (95%CI) 1.39-2.04, I-2=47%) and exposure to second-generation AP drugs (OR 1.98, 95%CI 1.67-2.35, I-2=36.7%). The risk was similar among different diagnostic categories and age groups, in elderly and young-adult populations; the finding on age was corroborated by a meta-regression analysis, which did not detect any relationship between age and risk of pneumonia. Only few studies provided data on individual drugs.ConclusionSystematic review of current observational evidence suggests that exposure to first-generation and second-generation AP drugs is associated with an increased risk of pneumonia. The present systematic review expands previous knowledge by showing that the increased risk not only applies to elderly individuals but also to younger patients. The information about the risk of pneumonia for individual compounds is still very limited. Copyright (c) 2015 John Wiley & Sons, Ltd.