Graduate Institute of Life Science, National Defense Medical Center, Taipei, Taiwan.
Sleep Research Center, Taipei Medical University Hospital, Taipei, Taiwan.
J Clin Pharmacol. 2018 Jun;58(6):727-732. doi: 10.1002/jcph.1067. Epub 2018 Jan 9.
To date, the actual relationship between antimuscarinics for overactive bladder (OAB) syndrome and the subsequent risk of a fracture remains unclear. The aim of this retrospective cohort study was to demonstrate the association between antimuscarinics for OAB and fractures using a large population-based data set. Data used in this study were taken from the Taiwan Longitudinal Health Insurance Database 2005. We identified 2927 OAB patients who received antimuscarinics as the study cohort and 11 708 matched OAB patients who did not receive antimuscarinics as the comparison cohort. Each individual was tracked for a 3-year period to define those who received a diagnosis of a fracture. Stratified Cox proportional hazard regression analyses were conducted to estimate the association between antimuscarinics for OAB and a subsequent fracture. Results revealed that the incidence rate of fracture per 100 person-years within the 3-year follow-up period were 3.01 (95% confidence interval [CI], 2.65-3.40) for OAB patients who received antimuscarinics and 2.77 (95%CI, 2.60-2.95) for those OAB patients who did not receive antimuscarinics. The adjusted hazard ratio (HR) for a subsequent fracture for OAB patients who received antimuscarinics was 1.11 (95%CI, 0.97-1.28) compared with those OAB patients who did not receive antimuscarinics. Consequently, we concluded that antimuscarinics for OAB was not significantly predictive of fracture.
迄今为止,抗胆碱能药物治疗膀胱过度活动症(OAB)与随后骨折风险之间的实际关系仍不清楚。本回顾性队列研究旨在使用大型基于人群的数据来证明 OAB 的抗胆碱能药物与骨折之间的关联。本研究使用的数据来自 2005 年台湾纵向健康保险数据库。我们确定了 2927 名接受抗胆碱能药物治疗的 OAB 患者作为研究队列,以及 11708 名未接受抗胆碱能药物治疗的匹配 OAB 患者作为对照队列。每个个体都进行了为期 3 年的跟踪,以确定那些被诊断为骨折的个体。进行分层 Cox 比例风险回归分析以估计 OAB 的抗胆碱能药物与随后骨折之间的关联。结果表明,在 3 年的随访期间,每 100 人年骨折发生率为 3.01(95%置信区间 [CI],2.65-3.40)接受抗胆碱能药物治疗的 OAB 患者和 2.77(95%CI,2.60-2.95)未接受抗胆碱能药物治疗的 OAB 患者。接受抗胆碱能药物治疗的 OAB 患者发生后续骨折的调整后风险比(HR)为 1.11(95%CI,0.97-1.28)与未接受抗胆碱能药物治疗的 OAB 患者相比。因此,我们得出结论,抗胆碱能药物治疗 OAB 与骨折无显著相关性。