Huang Yu-Hua, Pan Mei-Hung, Yang Hwai-I
Department of Neurology, Chang Gung Memorial Hospital Linkou Medical Center, Taoyuan, Taiwan.
College of Medicine, Chang-Gung University, Taoyuan, Taiwan.
Front Pharmacol. 2023 May 30;14:1128601. doi: 10.3389/fphar.2023.1128601. eCollection 2023.
Previous studies have shown that gabapentin or pregabalin use is associated with cognitive decline. Herein, we aimed to evaluate the association between gabapentin or pregabalin use and the risk of dementia. In this retrospective, population-based matched cohort study, all research data were collected from the 2005 Longitudinal Health Insurance Database, which contains data of 2 million people randomly selected from the National Health Insurance Research Database of Taiwan in 2005. The study extracted data from 1 January 2000, to 31 December 2017. Adult patients taking gabapentin or pregabalin were included in the exposure group, and patients not using gabapentin or pregabalin matched to exposure subjects in a 1:5 ratio by propensity scores composed of age, sex and index date were included in the non-exposure group. A total of 206,802 patients were enrolled in the study. Of them, 34,467 gabapentin- or pregabalin-exposure and 172,335 non-exposure patients were used for analysis. The mean follow-up day (±standard deviation) after the index date was 1724.76 (±1282.32) and 1881.45 (±1303.69) in the exposure and non-exposure groups, respectively; the incidence rates of dementia were 980.60 and 605.48 per 100,000 person-years, respectively. The multivariate-adjusted hazard ratio of risk of dementia for gabapentin or pregabalin exposure versus the matched non-exposed group was 1.45 (95% confidence interval [CI], 1.36-1.55). The risk of dementia increased with higher cumulative defined daily doses during the follow-up period. Moreover, the stratification analysis revealed that the risk of dementia associated with gabapentin or pregabalin exposure was significant in all age subgroups; however, it was higher in younger patients (age <50) than in the older patients (hazard ratio, 3.16; 95% CI, 2.23-4.47). Patients treated with gabapentin or pregabalin had an increased risk of dementia. Therefore, these drugs should be used with caution, particularly in susceptible individuals.
既往研究表明，使用加巴喷丁或普瑞巴林与认知功能下降有关。在此，我们旨在评估加巴喷丁或普瑞巴林的使用与痴呆风险之间的关联。在这项基于人群的回顾性匹配队列研究中，所有研究数据均收集自2005年纵向健康保险数据库，该数据库包含2005年从台湾国民健康保险研究数据库中随机选取的200万人的数据。研究提取了2000年1月1日至2017年12月31日的数据。服用加巴喷丁或普瑞巴林的成年患者被纳入暴露组，未使用加巴喷丁或普瑞巴林且根据年龄、性别和索引日期组成的倾向得分与暴露组受试者按1:5比例匹配的患者被纳入非暴露组。共有206,802名患者纳入研究。其中，34,467名加巴喷丁或普瑞巴林暴露患者和172,335名非暴露患者用于分析。暴露组和非暴露组在索引日期后的平均随访天数（±标准差）分别为1724.76（±1282.32）天和1881.45（±1303.69）天；痴呆发病率分别为每10万人年980.60例和605.48例。加巴喷丁或普瑞巴林暴露组与匹配的非暴露组相比，痴呆风险的多变量调整风险比为1.45（95%置信区间[CI]，1.36 - 1.55）。随访期间，痴呆风险随累积限定日剂量的增加而增加。此外，分层分析显示，加巴喷丁或普瑞巴林暴露相关的痴呆风险在所有年龄亚组中均显著；然而，年轻患者（年龄<50岁）的风险高于老年患者（风险比，3.16；95%CI，2.23 - 4.47）。接受加巴喷丁或普瑞巴林治疗的患者痴呆风险增加。因此，这些药物应谨慎使用，尤其是在易感个体中。
