Risk of parkinsonism and related movement disorders with gabapentinoids or tramadol: A case‐crossover study
Risk of parkinsonism and related movement disorders with gabapentinoids or tramadol: A case‐crossover study
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加巴喷丁类药物或曲马多导致帕金森病和相关运动障碍的风险：病例交叉研究
DOI：
10.1002/phar.2761
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发表时间：
2023
期刊：
影响因子：
--
通讯作者：
Kawakami Koji
中科院分区：
文献类型：
--
作者：
Ri Kairi;Fukasawa Toshiki;Yoshida Satomi;Takeuchi Masato;Kawakami Koji
引言通过审查个体病例报告和自发报告数据库中的数据挖掘，检测到了有关帕金森病和加巴喷丁类药物（加巴喷丁和普瑞巴林）或曲马多相关运动障碍的安全信号。需要精心设计的药物流行病学研究来评估signal. ESTA研究旨在调查的关联接触gabapentinoids或曲马多与帕金森综合征和相关的运动disorders.MethodsWe的风险进行了一项病例交叉研究，使用日本电子病历数据库。确定了2007年1月1日至2019年4月14日期间新诊断的帕金森综合征或相关运动障碍患者。结果的诊断日期定义为索引日期。我们评估了每例患者在索引日期前1天结束的90天危险期内和3个90天参考期内对加巴喷丁类药物或曲马多的暴露。采用多变量条件Logistic回归模型估计校正比值比（aOR）和95%置信区间（CI）。为了证实主要研究结果的稳健性，我们还使用病例-病例-时间-对照设计进行了敏感性分析，风险和参考期的时间窗不同，结局的定义不同，参考期的数量不同。暴露于加巴喷丁类（aOR，2.12; 95%CI，1.73-2.61）和曲马多（aOR，2.04; 95%CI，1.57-2.64）与风险增加相关。结果是一致的敏感性analysis.ConclusionOur研究结果作为一个谨慎的医生谁开gabapentinoids或曲马多在常规的临床实践。
IntroductionA safety signal concerning parkinsonism and related movement disorders with gabapentinoids (gabapentin and pregabalin) or tramadol was detected by reviewing individual case reports and data mining in spontaneous report databases. Well‐designed pharmacoepidemiological studies are needed to assess the signal.ObjectiveThis study aimed to investigate the association of exposure to gabapentinoids or tramadol with the risk of parkinsonism and related movement disorders.MethodsWe conducted a case‐crossover study using a Japanese electronic medical records database. Patients with newly diagnosed parkinsonism or related movement disorders between January 1, 2007, and April 14, 2019, were identified. The diagnosis date of outcomes was defined as the index date. We assessed the exposure of each patient to gabapentinoids or tramadol during a 90‐day hazard period ending 1 day before the index date and in three 90‐day reference periods. Multivariable conditional logistic regression models were employed to estimate adjusted odds ratios (aORs) and 95% confidence intervals (CIs). To confirm the robustness of the primary findings, we also performed sensitivity analyses using a case–case‐time‐control design, a different time window for hazard and reference periods, a different definition of outcome, and different number of reference periods.ResultsA total of 28,972 eligible cases were included in the primary analysis. Exposure to gabapentinoids (aOR, 2.12; 95% CI, 1.73–2.61) and tramadol (aOR, 2.04; 95% CI, 1.57–2.64) was associated with increased risk. Results were consistent across sensitivity analyses.ConclusionOur findings serve as a caution to physicians who prescribe gabapentinoids or tramadol in routine clinical practice.
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