Gabapentin and Pregabalin and Risk of Atrial Fibrillation in the Elderly

Gabapentin and pregabalin are widely prescribed to elderly people, but data on their pharmacokinetics, safety, and efficacy in this population are scarce. Neurological adverse effects are common. Atrial fibrillation (AF) associated with their use has been described in several case reports and case s...

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Autores: Ortiz de Landaluce, Leticia, Carbonell, Pere, Asensio Ostos, Carmen, Escoda, Núria, López, Pilar, Laporte Rosselló, Joan-Ramón|||0000-0001-9186-0097
Tipo de documento: artigo
Data de publicação:2018
País:España
Recursos:Universitat Autònoma de Barcelona
Repositório:Dipòsit Digital de Documents de la UAB
Idioma:inglês
OAI Identifier:oai:ddd.uab.cat:227936
Acesso em linha:https://ddd.uab.cat/record/227936
https://dx.doi.org/urn:doi:10.1007/s40264-018-0695-6
Access Level:Acceso aberto
Palavra-chave:Age factors
Aged
Adverse effects
Analgesics
Atrial fibrillation
Cohort studies
Diagnosis
Electronic prescribing
Epidemiology
Gabapentin
Humans
Population Surveillance
Pregabalin
Retrospective studies
Risk factors
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spelling Gabapentin and Pregabalin and Risk of Atrial Fibrillation in the ElderlyA Population-Based Cohort Study in an Electronic Prescription DatabaseOrtiz de Landaluce, LeticiaCarbonell, PereAsensio Ostos, CarmenEscoda, NúriaLópez, PilarLaporte Rosselló, Joan-Ramón|||0000-0001-9186-0097Age factorsAgedAdverse effectsAnalgesicsAtrial fibrillationCohort studiesDiagnosisElectronic prescribingEpidemiologyGabapentinHumansPopulation SurveillancePregabalinRetrospective studiesRisk factorsGabapentin and pregabalin are widely prescribed to elderly people, but data on their pharmacokinetics, safety, and efficacy in this population are scarce. Neurological adverse effects are common. Atrial fibrillation (AF) associated with their use has been described in several case reports and case series, but the incidence is unknown. The aim of this study was to assess the association between exposure to gabapentin or pregabalin and AF in the elderly. Patients ≥ 65 years of age starting treatment with either gabapentin or pregabalin between January 1 and March 31, 2015, free of cardiovascular disease, and who did not receive the alternate study medications were studied. They were compared with patients who initiated treatment with an analgesic opiate or with alprazolam or diazepam. The two primary outcome variables were a first claim of an oral anticoagulant plus an antiarrhythmic drug (OAC + AA), or of an oral anticoagulant or an antiplatelet agent plus an antiarrhythmic drug (OAC/APA + AA), in the 3 months after treatment initiation. Compared with opiate analgesics, both gabapentin and pregabalin were associated with an increased risk of initiating OAC/APA + AA. The incidence was 6 of 668 (9.0 per 1000 patients) with gabapentin, versus 12 of 3889 (3.1 per 1000) with opiates, relative risk (RR) 2.91 (95% confidence interval [CI] 1.10-7.73), and for pregabalin it was 6 of 698 (8.6 per 1000) RR 2.79 (95% CI 1.05-7.40). The comparison with alprazolam/diazepam gave similar results. The risks did not vary by age, sex, or co-treatment with NSAIDs, and they increased with dose. In elderly patients free of cardiovascular disease, an association between new exposure to gabapentin or pregabalin and initiating treatment for AF was found. These results should be confirmed in other studies. The online version of this article (10.1007/s40264-018-0695-6) contains supplementary material, which is available to authorized users.Universitat Autònoma de Barcelona 22018-01-0120182018-01-01Articlehttp://purl.org/coar/resource_type/c_6501VoRhttp://purl.org/coar/version/c_970fb48d4fbd8a85info:eu-repo/semantics/articleapplication/pdfhttps://ddd.uab.cat/record/227936https://dx.doi.org/urn:doi:10.1007/s40264-018-0695-6reponame:Dipòsit Digital de Documents de la UABinstname:Universitat Autònoma de BarcelonaInglésengopen accesshttp://purl.org/coar/access_right/c_abf2Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original.https://creativecommons.org/licenses/by-nc/4.0/info:eu-repo/semantics/openAccessoai:ddd.uab.cat:2279362026-06-06T12:50:31Z
dc.title.none.fl_str_mv Gabapentin and Pregabalin and Risk of Atrial Fibrillation in the Elderly
A Population-Based Cohort Study in an Electronic Prescription Database
title Gabapentin and Pregabalin and Risk of Atrial Fibrillation in the Elderly
spellingShingle Gabapentin and Pregabalin and Risk of Atrial Fibrillation in the Elderly
Ortiz de Landaluce, Leticia
Age factors
Aged
Adverse effects
Analgesics
Atrial fibrillation
Cohort studies
Diagnosis
Electronic prescribing
Epidemiology
Gabapentin
Humans
Population Surveillance
Pregabalin
Retrospective studies
Risk factors
title_short Gabapentin and Pregabalin and Risk of Atrial Fibrillation in the Elderly
title_full Gabapentin and Pregabalin and Risk of Atrial Fibrillation in the Elderly
title_fullStr Gabapentin and Pregabalin and Risk of Atrial Fibrillation in the Elderly
title_full_unstemmed Gabapentin and Pregabalin and Risk of Atrial Fibrillation in the Elderly
title_sort Gabapentin and Pregabalin and Risk of Atrial Fibrillation in the Elderly
dc.creator.none.fl_str_mv Ortiz de Landaluce, Leticia
Carbonell, Pere
Asensio Ostos, Carmen
Escoda, Núria
López, Pilar
Laporte Rosselló, Joan-Ramón|||0000-0001-9186-0097
author Ortiz de Landaluce, Leticia
author_facet Ortiz de Landaluce, Leticia
Carbonell, Pere
Asensio Ostos, Carmen
Escoda, Núria
López, Pilar
Laporte Rosselló, Joan-Ramón|||0000-0001-9186-0097
author_role author
author2 Carbonell, Pere
Asensio Ostos, Carmen
Escoda, Núria
López, Pilar
Laporte Rosselló, Joan-Ramón|||0000-0001-9186-0097
author2_role author
author
author
author
author
dc.contributor.none.fl_str_mv Universitat Autònoma de Barcelona
dc.subject.none.fl_str_mv Age factors
Aged
Adverse effects
Analgesics
Atrial fibrillation
Cohort studies
Diagnosis
Electronic prescribing
Epidemiology
Gabapentin
Humans
Population Surveillance
Pregabalin
Retrospective studies
Risk factors
topic Age factors
Aged
Adverse effects
Analgesics
Atrial fibrillation
Cohort studies
Diagnosis
Electronic prescribing
Epidemiology
Gabapentin
Humans
Population Surveillance
Pregabalin
Retrospective studies
Risk factors
description Gabapentin and pregabalin are widely prescribed to elderly people, but data on their pharmacokinetics, safety, and efficacy in this population are scarce. Neurological adverse effects are common. Atrial fibrillation (AF) associated with their use has been described in several case reports and case series, but the incidence is unknown. The aim of this study was to assess the association between exposure to gabapentin or pregabalin and AF in the elderly. Patients ≥ 65 years of age starting treatment with either gabapentin or pregabalin between January 1 and March 31, 2015, free of cardiovascular disease, and who did not receive the alternate study medications were studied. They were compared with patients who initiated treatment with an analgesic opiate or with alprazolam or diazepam. The two primary outcome variables were a first claim of an oral anticoagulant plus an antiarrhythmic drug (OAC + AA), or of an oral anticoagulant or an antiplatelet agent plus an antiarrhythmic drug (OAC/APA + AA), in the 3 months after treatment initiation. Compared with opiate analgesics, both gabapentin and pregabalin were associated with an increased risk of initiating OAC/APA + AA. The incidence was 6 of 668 (9.0 per 1000 patients) with gabapentin, versus 12 of 3889 (3.1 per 1000) with opiates, relative risk (RR) 2.91 (95% confidence interval [CI] 1.10-7.73), and for pregabalin it was 6 of 698 (8.6 per 1000) RR 2.79 (95% CI 1.05-7.40). The comparison with alprazolam/diazepam gave similar results. The risks did not vary by age, sex, or co-treatment with NSAIDs, and they increased with dose. In elderly patients free of cardiovascular disease, an association between new exposure to gabapentin or pregabalin and initiating treatment for AF was found. These results should be confirmed in other studies. The online version of this article (10.1007/s40264-018-0695-6) contains supplementary material, which is available to authorized users.
publishDate 2018
dc.date.none.fl_str_mv 2
2018-01-01
2018
2018-01-01
dc.type.none.fl_str_mv Article
http://purl.org/coar/resource_type/c_6501
VoR
http://purl.org/coar/version/c_970fb48d4fbd8a85
dc.type.openaire.fl_str_mv info:eu-repo/semantics/article
format article
dc.identifier.none.fl_str_mv https://ddd.uab.cat/record/227936
https://dx.doi.org/urn:doi:10.1007/s40264-018-0695-6
url https://ddd.uab.cat/record/227936
https://dx.doi.org/urn:doi:10.1007/s40264-018-0695-6
dc.language.none.fl_str_mv Inglés
eng
language_invalid_str_mv Inglés
language eng
dc.rights.none.fl_str_mv open access
http://purl.org/coar/access_right/c_abf2
https://creativecommons.org/licenses/by-nc/4.0/
dc.rights.openaire.fl_str_mv info:eu-repo/semantics/openAccess
rights_invalid_str_mv open access
http://purl.org/coar/access_right/c_abf2
https://creativecommons.org/licenses/by-nc/4.0/
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.source.none.fl_str_mv reponame:Dipòsit Digital de Documents de la UAB
instname:Universitat Autònoma de Barcelona
instname_str Universitat Autònoma de Barcelona
reponame_str Dipòsit Digital de Documents de la UAB
collection Dipòsit Digital de Documents de la UAB
repository.name.fl_str_mv
repository.mail.fl_str_mv
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