Atypical Antipsychotics and the Risk of Hyperlipidemia: A Sequence Symmetry Analysis

被引:23
|
作者
Takeuchi, Yoshinori [1 ]
Kajiyama, Kazuhiro [1 ]
Ishiguro, Chieko [1 ]
Uyama, Yoshiaki [1 ]
机构
[1] Pharmaceut & Med Devices Agcy, Off Med Informat & Epidemiol, Chiyoda Ku, Tokyo 1000013, Japan
关键词
OLANZAPINE-TREATED PATIENTS; TRIGLYCERIDE LEVELS; SCHIZOPHRENIA; PRESCRIPTION; WEIGHT; MEDICATION; EXPRESSION; INSULIN; LEPTIN; LIPIDS;
D O I
10.1007/s40264-015-0298-4
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
Introduction Although hyperlipidemia is a well known adverse event of atypical antipsychotic (AAP) medication, there are few studies that have quantitatively compared the risks of various AAPs. Objective Our aim was to comparatively evaluate the risk of hyperlipidemia associated with the use of AAPs approved in Japan through a consecutive epidemiological study. Methods We conducted a sequence symmetry analysis (SSA) using health insurance claims data to analyze the following nine AAPs approved for use in Japan: risperidone, paliperidone, perospirone hydrochloride hydrate, blonanserin, clozapine, olanzapine, quetiapine fumarate, aripiprazole, and zotepine. Exposed cases were identified from drug dispensing records as those who had been administered both AAPs and antihyperlipidemic drugs. The adjusted sequence ratio (ASR) and 95 % confidence interval (CI) for each individual AAP and for all AAPs were calculated while controlling for time trends in dispensing patterns. Results Olanzapine was significantly associated with increased hyperlipidemia occurrence (ASR 1.56; 95 % CI 1.25-1.95). The ASRs obtained for risperidone (1.01; 95 % CI 0.80-1.27), perospirone hydrochloride hydrate (0.93; 95 % CI 0.63-1.39), blonanserin (0.83; 95 % CI 0.52-1.33), quetiapine fumarate (0.93; 95 % CI 0.73-1.18), and aripiprazole (1.02; 95 % CI 0.82-1.26) were approximately 1.0. Unstable estimates (wide CIs) were obtained for paliperidone and zotepine due to the small sample sizes. Conclusions Among the AAPs used in Japan, only olanzapine was found to have an elevated risk of hyperlipidemia. In contrast, risperidone, perospirone hydrochloride hydrate, blonanserin, quetiapine fumarate, and aripiprazole had relatively low risks.
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页码:641 / 650
页数:10
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