Gasse Christiane, Jacobsen Jacob, Pedersen Lars, Mortensen Preben Bo, Nørgaard Mette, Sørensen Henrik Toft, Johnsen Søren Paaske
Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark.
Pharmacotherapy. 2008 Jan;28(1):27-34. doi: 10.1592/phco.28.1.27.
To examine the association of atypical and conventional antipsychotics with the risk of hospitalization for acute pancreatitis.
Population-based, case-control study.
Health care databases of Northern Denmark.
A total of 3083 adults hospitalized with acute pancreatitis (case patients) and 30,830 control subjects.
Controls were selected from the general population by using risk-set sampling and were matched to case patients by age and sex. The date of the case patients' admission for acute pancreatitis was used as the index date for the matched control subjects. Conditional logistic regression analysis was used to estimate rate ratios (RRs) for hospitalization due to acute pancreatitis in current users (0-90 days before admission or index date) and former users (> 90 days before admission or index date) of atypical and conventional antipsychotics compared with nonusers of the respective antipsychotics, while controlling for covariates and stratifying by age. Fifteen case patients (0.5%) were current users of atypical antipsychotics, and 128 case patients (4.2%) were current users of conventional antipsychotics. Adjusted RRs for current use and former use of atypical antipsychotics were 0.6 (95% confidence interval [CI] 0.3-1.1) and 0.3 (95% CI 0.1-0.9), respectively. A trend was noted for increasing risk of hospitalization due to acute pancreatitis with decreasing potency of conventional antipsychotics, with adjusted RRs of 1.2 (95% CI 0.7-2.0) for high-potency, 1.5 (95% CI 1.0-2.2) for intermediate-potency, and 2.8 (95% CI 2.0-3.8) for low-potency conventional antipsychotics, which was largely age-modified with an adjusted RR of 5.2 (95% CI 3.2-8.5) in patients younger than 60 years, compared with an adjusted RR of 1.5 (95% CI 0.9-2.5) in older users. Former use of conventional antipsychotics of any kind was associated with an adjusted RR of 1.6 (95% CI 1.4-1.9).
Current use of low-potency conventional, but not atypical, antipsychotics was associated with an increased risk of hospitalization for acute pancreatitis.
探讨非典型抗精神病药物和传统抗精神病药物与急性胰腺炎住院风险之间的关联。
基于人群的病例对照研究。
丹麦北部的医疗保健数据库。
共有3083例因急性胰腺炎住院的成年人（病例患者）和30830例对照受试者。
通过风险集抽样从普通人群中选取对照，并按年龄和性别与病例患者进行匹配。将病例患者因急性胰腺炎入院的日期作为匹配对照受试者的索引日期。采用条件逻辑回归分析，估计非典型抗精神病药物和传统抗精神病药物的当前使用者（入院前或索引日期前0 - 90天）和既往使用者（入院前或索引日期前> 90天）与各自抗精神病药物非使用者相比，因急性胰腺炎住院的率比（RRs），同时控制协变量并按年龄分层。15例病例患者（0.5%）为非典型抗精神病药物的当前使用者，128例病例患者（4.2%）为传统抗精神病药物的当前使用者。非典型抗精神病药物当前使用和既往使用的调整后RR分别为0.6（95%置信区间[CI] 0.3 - 1.1）和0.3（95% CI 0.1 - 0.9）。注意到随着传统抗精神病药物效力降低，因急性胰腺炎住院的风险呈上升趋势，高效力传统抗精神病药物的调整后RR为1.2（95% CI 0.7 - 2.0），中效力为1.5（95% CI 1.0 - 2.2），低效力为2.8（95% CI 2.0 - 3.8），在很大程度上受年龄影响，60岁以下患者的调整后RR为5.2（95% CI 3.2 - 8.5），而老年使用者的调整后RR为1.5（95% CI 0.9 - 2.5）。任何一种传统抗精神病药物的既往使用与调整后RR为1.6（95% CI 1.4 - 1.9）相关。
当前使用低效传统抗精神病药物而非非典型抗精神病药物与急性胰腺炎住院风险增加相关。
