TY - JOUR
T1 - All-cause mortality and antipsychotic use among elderly persons with high baseline cardiovascular and cerebrovascular risk
T2 - a multi-center retrospective cohort study in Italy
AU - Sultana, Janet
AU - Giorgianni, Francesco
AU - Rea, Federico
AU - Lucenteforte, Ersilia
AU - Lombardi, Niccolò
AU - Mugelli, Alessandro
AU - Vannacci, Alfredo
AU - Liperoti, Rosa
AU - Kirchmayer, Ursula
AU - Vitale, Cristiana
AU - Chinellato, Alessandro
AU - Roberto, Giuseppe
AU - Corrao, Giovanni
AU - Trifirò, Gianluca
PY - 2019/2/1
Y1 - 2019/2/1
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.
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.
KW - Antipsychotics
KW - cohort study
KW - drug interactions
KW - elderly
KW - mortality
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U2 - 10.1080/17425255.2019.1561860
DO - 10.1080/17425255.2019.1561860
M3 - Article
C2 - 30572727
AN - SCOPUS:85059635244
VL - 15
SP - 179
EP - 188
JO - Expert Opinion on Drug Metabolism and Toxicology
JF - Expert Opinion on Drug Metabolism and Toxicology
SN - 1742-5255
IS - 2
ER -