Valladales-Restrepo Luis Fernando, Machado-Alba Jorge Enrique
Grupo de Investigación en Farmacoepidemiología y Farmacovigilancia, Universidad Tecnológica de Pereira-Audifarma S.A, Calle 105 No. 14-140, Pereira, Risaralda, Colombia Pereira, Risaralda, Colombia.
Grupo de Investigación Biomedicina, Fundación Universitaria Autónoma de las Américas, Ave Las Américas, # 98-56, Pereira, Colombia.
J Transl Autoimmun. 2019 Jun 27;2:100007. doi: 10.1016/j.jtauto.2019.100007. eCollection 2019 Dec.
Sjögren's syndrome is characterized by the involvement of exocrine glands, manifesting with xerostomia and xerophthalmia. The objective was to determine the treatment received and identify potentially inappropriate prescriptions by estimating the anticholinergic burden generated by medications in patients with Sjögren's syndrome in Colombia. This cross-sectional study was based on a population database that identified patients with Sjögren's syndrome, comorbidities, pharmacological treatment, and medications with anticholinergic properties. The anticholinergic burden was estimated using the Anticholinergic Drug Scale. A total of 4945 patients with Sjögren's syndrome were identified, with a mean age of 64.6 ± 14.04 years and 75.7% women. A total of 79.0% received a topical lubricant, with hyaluronate being the most prescribed (26.8%), while oral pilocarpine was prescribed for 7.4%. The use of biological disease-modifying antirheumatic drugs was identified in 1.3% of cases. A total of 39.1% (n = 1932) of all patients received cholinergic antagonists, especially codeine (6.5%), prednisolone (5.7%), and furosemide (5.3%). The mean anticholinergic burden was 0.91 ± 1.57 (range: 0-24), 17.2% (n = 850) had a score of 1, 7.7% (n = 381) had a score of 2, and 14.2% (n = 701) ≥3 points. Multiple comorbidities were associated with the risk of having cholinergic antagonist medication prescribed. Most patients with Sjögren's syndrome were women whose symptomatic management mainly included ocular lubricants with low use of oral pilocarpine. A large proportion of patients had at least one cholinergic antagonist drug prescribed, increasing its use risk after 40 years of age.
干燥综合征的特征是外分泌腺受累，表现为口干和眼干。目的是通过估计哥伦比亚干燥综合征患者药物产生的抗胆碱能负担，确定其接受的治疗并识别潜在不适当的处方。这项横断面研究基于一个人口数据库，该数据库识别了干燥综合征患者、合并症、药物治疗以及具有抗胆碱能特性的药物。使用抗胆碱能药物量表估计抗胆碱能负担。共识别出4945例干燥综合征患者，平均年龄为64.6±14.04岁，女性占75.7%。共有79.0%的患者接受了局部润滑剂治疗，其中透明质酸盐是最常开具的药物（26.8%），而口服毛果芸香碱的处方率为7.4%。1.3%的病例使用了生物性改善病情抗风湿药物。所有患者中共有39.1%（n = 1932）接受了胆碱能拮抗剂治疗，尤其是可待因（6.5%）、泼尼松龙（5.7%）和呋塞米（5.3%）。抗胆碱能负担的平均值为0.91±1.57（范围：0 - 24），17.2%（n = 850）的患者评分为1分，7.7%（n = 381）的患者评分为2分，14.2%（n = 701）的患者评分≥3分。多种合并症与开具胆碱能拮抗剂药物的风险相关。大多数干燥综合征患者为女性，其症状管理主要包括眼部润滑剂，口服毛果芸香碱的使用较少。很大一部分患者至少开具了一种胆碱能拮抗剂药物，40岁后其使用风险增加。
