All-cause mortality and antipsychotic use among elderly persons with high baseline cardiovascular and cerebrovascular risk: a multi-center retrospective cohort study in Italy

J. Sultana, F. Giorgianni, F. Rea, E. Lucenteforte, N. Lombardi, A. Mugelli, A. Vannacci, R. Liperoti, U. Kirchmayer, C. Vitale, A. Chinellato, G. Roberto, G. Corrao, G. Trifirò, N. Agabiti, C. Bartolini, R. Bernabei, A. Bettiol, S. Bonassi, A.P. Caputi & 11 others S. Cascini, F. Cipriani, M. Davoli, M. Fini, R. Gini, F. Lapi, G. Onder, C. Sorge, M. Tari, D.L. Vetrano, on the behalf of the Italian Group for Appropriate Drug prescription in the Elderly (I-GrADE)

Research output: Contribution to journalArticle

Abstract

Background: Little is known about the comparative risk of death with atypical or conventional antipsychotics (APs) among persons with cardiovascular or cerebrovascular disease (CCD). Research design and methods: A cohort study was conducted using five Italian claims databases. New atypical AP users with CCD aged ≥65 (reference) were matched to new conventional AP users. Mortality per 100 person-years (PYs) and hazard ratios (HR), estimated using Cox models, were reported. Incidence and risk of death were estimated for persons having drug–drug interactions. Outcome occurrence was evaluated 180 days after AP initiation. Results: Overall 24,711 and 27,051 elderly new conventional and atypical AP users were identified. The mortality rate was 51.3 and 38.5 deaths per 100 PYs for conventional and atypical AP users. Mortality risk was 1.33 (95%CI: 1.27–1.39) for conventional APs. There was no increased mortality risk with single drug–drug interactions (DDIs) vs. no DDI. AP users with ≥1 DDI had a 29% higher mortality risk compared to no DDI in the first 90 days of treatment (HR: 1.29 (95% CI: 1.00–1.67)). Conclusions: Conventional APs had a higher risk of death than atypical APs among elderly persons with CCD. Having ≥1 DDI was associated with an increased risk of death. © 2019, © 2019 Informa UK Limited, trading as Taylor & Francis Group.
LanguageEnglish
Pages179-188
Number of pages10
JournalExpert Opinion on Drug Metabolism and Toxicology
Volume15
Issue number2
DOIs
Publication statusPublished - 2019

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All-cause mortality and antipsychotic use among elderly persons with high baseline cardiovascular and cerebrovascular risk: a multi-center retrospective cohort study in Italy. / Sultana, J.; Giorgianni, F.; Rea, F.; Lucenteforte, E.; Lombardi, N.; Mugelli, A.; Vannacci, A.; Liperoti, R.; Kirchmayer, U.; Vitale, C.; Chinellato, A.; Roberto, G.; Corrao, G.; Trifirò, G.; Agabiti, N.; Bartolini, C.; Bernabei, R.; Bettiol, A.; Bonassi, S.; Caputi, A.P.; Cascini, S.; Cipriani, F.; Davoli, M.; Fini, M.; Gini, R.; Lapi, F.; Onder, G.; Sorge, C.; Tari, M.; Vetrano, D.L.; (I-GrADE), on the behalf of the Italian Group for Appropriate Drug prescription in the Elderly.

In: Expert Opinion on Drug Metabolism and Toxicology, Vol. 15, No. 2, 2019, p. 179-188.

Research output: Contribution to journalArticle

Sultana, J, Giorgianni, F, Rea, F, Lucenteforte, E, Lombardi, N, Mugelli, A, Vannacci, A, Liperoti, R, Kirchmayer, U, Vitale, C, Chinellato, A, Roberto, G, Corrao, G, Trifirò, G, Agabiti, N, Bartolini, C, Bernabei, R, Bettiol, A, Bonassi, S, Caputi, AP, Cascini, S, Cipriani, F, Davoli, M, Fini, M, Gini, R, Lapi, F, Onder, G, Sorge, C, Tari, M, Vetrano, DL & (I-GrADE), OTBOTIGFADPITE 2019, 'All-cause mortality and antipsychotic use among elderly persons with high baseline cardiovascular and cerebrovascular risk: a multi-center retrospective cohort study in Italy', Expert Opinion on Drug Metabolism and Toxicology, vol. 15, no. 2, pp. 179-188. https://doi.org/10.1080/17425255.2019.1561860
Sultana, J. ; Giorgianni, F. ; Rea, F. ; Lucenteforte, E. ; Lombardi, N. ; Mugelli, A. ; Vannacci, A. ; Liperoti, R. ; Kirchmayer, U. ; Vitale, C. ; Chinellato, A. ; Roberto, G. ; Corrao, G. ; Trifirò, G. ; Agabiti, N. ; Bartolini, C. ; Bernabei, R. ; Bettiol, A. ; Bonassi, S. ; Caputi, A.P. ; Cascini, S. ; Cipriani, F. ; Davoli, M. ; Fini, M. ; Gini, R. ; Lapi, F. ; Onder, G. ; Sorge, C. ; Tari, M. ; Vetrano, D.L. ; (I-GrADE), on the behalf of the Italian Group for Appropriate Drug prescription in the Elderly. / All-cause mortality and antipsychotic use among elderly persons with high baseline cardiovascular and cerebrovascular risk: a multi-center retrospective cohort study in Italy. In: Expert Opinion on Drug Metabolism and Toxicology. 2019 ; Vol. 15, No. 2. pp. 179-188.
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abstract = "Background: Little is known about the comparative risk of death with atypical or conventional antipsychotics (APs) among persons with cardiovascular or cerebrovascular disease (CCD). Research design and methods: A cohort study was conducted using five Italian claims databases. New atypical AP users with CCD aged ≥65 (reference) were matched to new conventional AP users. Mortality per 100 person-years (PYs) and hazard ratios (HR), estimated using Cox models, were reported. Incidence and risk of death were estimated for persons having drug–drug interactions. Outcome occurrence was evaluated 180 days after AP initiation. Results: Overall 24,711 and 27,051 elderly new conventional and atypical AP users were identified. The mortality rate was 51.3 and 38.5 deaths per 100 PYs for conventional and atypical AP users. Mortality risk was 1.33 (95{\%}CI: 1.27–1.39) for conventional APs. There was no increased mortality risk with single drug–drug interactions (DDIs) vs. no DDI. AP users with ≥1 DDI had a 29{\%} higher mortality risk compared to no DDI in the first 90 days of treatment (HR: 1.29 (95{\%} CI: 1.00–1.67)). Conclusions: Conventional APs had a higher risk of death than atypical APs among elderly persons with CCD. Having ≥1 DDI was associated with an increased risk of death. {\circledC} 2019, {\circledC} 2019 Informa UK Limited, trading as Taylor & Francis Group.",
author = "J. Sultana and F. Giorgianni and F. Rea and E. Lucenteforte and N. Lombardi and A. Mugelli and A. Vannacci and R. Liperoti and U. Kirchmayer and C. Vitale and A. Chinellato and G. Roberto and G. Corrao and G. Trifir{\`o} and N. Agabiti and C. Bartolini and R. Bernabei and A. Bettiol and S. Bonassi and A.P. Caputi and S. Cascini and F. Cipriani and M. Davoli and M. Fini and R. Gini and F. Lapi and G. Onder and C. Sorge and M. Tari and D.L. Vetrano and (I-GrADE), {on the behalf of the Italian Group for Appropriate Drug prescription in the Elderly}",
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T1 - All-cause mortality and antipsychotic use among elderly persons with high baseline cardiovascular and cerebrovascular risk: a multi-center retrospective cohort study in Italy

AU - Sultana, J.

AU - Giorgianni, F.

AU - Rea, F.

AU - Lucenteforte, E.

AU - Lombardi, N.

AU - Mugelli, A.

AU - Vannacci, A.

AU - Liperoti, R.

AU - Kirchmayer, U.

AU - Vitale, C.

AU - Chinellato, A.

AU - Roberto, G.

AU - Corrao, G.

AU - Trifirò, G.

AU - Agabiti, N.

AU - Bartolini, C.

AU - Bernabei, R.

AU - Bettiol, A.

AU - Bonassi, S.

AU - Caputi, A.P.

AU - Cascini, S.

AU - Cipriani, F.

AU - Davoli, M.

AU - Fini, M.

AU - Gini, R.

AU - Lapi, F.

AU - Onder, G.

AU - Sorge, C.

AU - Tari, M.

AU - Vetrano, D.L.

AU - (I-GrADE), on the behalf of the Italian Group for Appropriate Drug prescription in the Elderly

N1 - cited By 0

PY - 2019

Y1 - 2019

N2 - Background: Little is known about the comparative risk of death with atypical or conventional antipsychotics (APs) among persons with cardiovascular or cerebrovascular disease (CCD). Research design and methods: A cohort study was conducted using five Italian claims databases. New atypical AP users with CCD aged ≥65 (reference) were matched to new conventional AP users. Mortality per 100 person-years (PYs) and hazard ratios (HR), estimated using Cox models, were reported. Incidence and risk of death were estimated for persons having drug–drug interactions. Outcome occurrence was evaluated 180 days after AP initiation. Results: Overall 24,711 and 27,051 elderly new conventional and atypical AP users were identified. The mortality rate was 51.3 and 38.5 deaths per 100 PYs for conventional and atypical AP users. Mortality risk was 1.33 (95%CI: 1.27–1.39) for conventional APs. There was no increased mortality risk with single drug–drug interactions (DDIs) vs. no DDI. AP users with ≥1 DDI had a 29% higher mortality risk compared to no DDI in the first 90 days of treatment (HR: 1.29 (95% CI: 1.00–1.67)). Conclusions: Conventional APs had a higher risk of death than atypical APs among elderly persons with CCD. Having ≥1 DDI was associated with an increased risk of death. © 2019, © 2019 Informa UK Limited, trading as Taylor & Francis Group.

AB - Background: Little is known about the comparative risk of death with atypical or conventional antipsychotics (APs) among persons with cardiovascular or cerebrovascular disease (CCD). Research design and methods: A cohort study was conducted using five Italian claims databases. New atypical AP users with CCD aged ≥65 (reference) were matched to new conventional AP users. Mortality per 100 person-years (PYs) and hazard ratios (HR), estimated using Cox models, were reported. Incidence and risk of death were estimated for persons having drug–drug interactions. Outcome occurrence was evaluated 180 days after AP initiation. Results: Overall 24,711 and 27,051 elderly new conventional and atypical AP users were identified. The mortality rate was 51.3 and 38.5 deaths per 100 PYs for conventional and atypical AP users. Mortality risk was 1.33 (95%CI: 1.27–1.39) for conventional APs. There was no increased mortality risk with single drug–drug interactions (DDIs) vs. no DDI. AP users with ≥1 DDI had a 29% higher mortality risk compared to no DDI in the first 90 days of treatment (HR: 1.29 (95% CI: 1.00–1.67)). Conclusions: Conventional APs had a higher risk of death than atypical APs among elderly persons with CCD. Having ≥1 DDI was associated with an increased risk of death. © 2019, © 2019 Informa UK Limited, trading as Taylor & Francis Group.

U2 - 10.1080/17425255.2019.1561860

DO - 10.1080/17425255.2019.1561860

M3 - Article

VL - 15

SP - 179

EP - 188

JO - Expert Opinion on Drug Metabolism and Toxicology

T2 - Expert Opinion on Drug Metabolism and Toxicology

JF - Expert Opinion on Drug Metabolism and Toxicology

SN - 1742-5255

IS - 2

ER -