Ho Joanne M-W, Macdonald Erin M, Luo Jin, Gomes Tara, Antoniou Tony, Mamdani Muhammad M, Juurlink David N
Department of Medicine, University of Toronto, Toronto, ON, Canada.
The Institute for Clinical Evaluative Sciences, Toronto, ON, Canada.
Pharmacoepidemiol Drug Saf. 2017 Sep;26(9):1087-1092. doi: 10.1002/pds.4239. Epub 2017 Jun 16.
The anticonvulsant pregabalin is increasingly prescribed for pain, seizures, and psychiatric disorders. Although evidence suggests pregabalin can cause edema and heart failure, its cardiac safety profile in clinical practice is unknown. We sought to examine the risk of heart failure among older patients receiving pregabalin compared to those receiving gabapentin.
We conducted a population-based cohort study of Ontarians aged 66 and older with a history of seizure who received pregabalin or gabapentin between April 2013 and March 2014. We used propensity scores to match patients commencing pregabalin to those commencing gabapentin. The primary outcome was an emergency department visit or hospitalization for heart failure within 90 days.
We studied 9855 patients who initiated pregabalin and an equal number treated with gabapentin. In the primary analysis, we found no difference in the risk of heart failure with pregabalin compared to gabapentin (1.2% versus 1.3%, hazard ratio of 0.77; 95% CI 0.58-1.03). Secondary analyses stratified for baseline history of heart failure yielded similar findings.
In a large cohort of older patients with a seizure disorder, pregabalin was not associated with an increased risk of heart failure relative to gabapentin.
抗惊厥药物普瑞巴林越来越多地被用于治疗疼痛、癫痫和精神疾病。尽管有证据表明普瑞巴林可导致水肿和心力衰竭，但其在临床实践中的心脏安全性尚不明确。我们旨在研究与服用加巴喷丁的老年患者相比，服用普瑞巴林的老年患者发生心力衰竭的风险。
我们对2013年4月至2014年3月期间有癫痫病史且年龄在66岁及以上的安大略省居民进行了一项基于人群的队列研究，这些患者接受了普瑞巴林或加巴喷丁治疗。我们使用倾向评分将开始服用普瑞巴林的患者与开始服用加巴喷丁的患者进行匹配。主要结局是90天内因心力衰竭到急诊科就诊或住院。
我们研究了9855例开始服用普瑞巴林的患者以及相同数量服用加巴喷丁的患者。在初步分析中，我们发现与加巴喷丁相比，普瑞巴林导致心力衰竭的风险没有差异（分别为1.2%和1.3%，风险比为0.77；95%可信区间为0.58 - 1.03）。对心力衰竭基线病史进行分层的二次分析得出了类似的结果。
在一大群患有癫痫症的老年患者中，与加巴喷丁相比，普瑞巴林与心力衰竭风险增加无关。
