Bezin Julien, Noize Pernelle, Mansiaux Yohann, Jarne Ana, Pariente Antoine
Bordeaux Population Health Research Center, Team Pharmacoepidemiology, UMR 1219, Inserm, DRUGS-SAFE National Platform of Pharmacoepidemiology, University Bordeaux, Service de Pharmacologie Médicale, CHU Bordeaux, Bordeaux, France.
Bordeaux Population Health Research Center, Team Pharmacoepidemiology, UMR 1219, Inserm, DRUGS-SAFE National Platform of Pharmacoepidemiology, University Bordeaux, Bordeaux, France.
Br J Clin Pharmacol. 2021 Mar;87(3):1303-1309. doi: 10.1111/bcp.14510. Epub 2020 Aug 12.
The aim of this study was to evaluate the risk of trauma associated with the use of antidopaminergic antiemetics in a real-world setting.
A self-controlled case series analysis was performed using the EGB database, the representative sample of the French national healthcare insurance system database. All subjects aged 18 years and over who presented with at least 1 trauma-related hospitalization and 1 supply for domperidone, metoclopramide or metopimazine between 2009 and 2014 were included in the study. Associations were evaluated by incidence rate ratios.
Included exposed cases were 7610 for domperidone cohort, 2189 for metoclopramide and 3911 for metopimazine. Incidence rate ratio for trauma-related hospitalization during the first 7 days of exposure period compared to unexposed period was 1.53 (95% confidence interval 1.29-1.80) for domperidone, 2.00 (1.37-2.91) for metoclopramide and 2.30 (1.71-3.09) for metopimazine.
We found an increased risk of hospitalizations for traumatic injuries for the main marketed antidopaminergic antiemetics during the first days of use. The highest risk was observed for metopimazine, which could relate to its pharmacological profile and central effects.
本研究旨在评估在实际应用中使用抗多巴胺能止吐药相关的创伤风险。
使用法国国家医疗保险系统数据库的代表性样本EGB数据库进行自我对照病例系列分析。纳入2009年至2014年间至少有1次与创伤相关住院且有1次多潘立酮、甲氧氯普胺或美托哌丙嗪用药记录的18岁及以上所有受试者。通过发病率比评估相关性。
纳入的暴露病例中，多潘立酮队列有7610例，甲氧氯普胺有2189例，美托哌丙嗪有3911例。与未暴露期相比，暴露期前7天与创伤相关住院的发病率比，多潘立酮为1.53（95%置信区间1.29 - 1.80），甲氧氯普胺为2.00（1.37 - 2.91），美托哌丙嗪为2.30（1.71 - 3.09）。
我们发现主要上市的抗多巴胺能止吐药在使用的最初几天内创伤性损伤住院风险增加。美托哌丙嗪的风险最高，这可能与其药理特性和中枢作用有关。
