1996年至2019年加拿大6个省份雷尼替丁的处方使用情况及人群暴露情况：一项系列横断面分析

Prescription ranitidine use and population exposure in 6 Canadian provinces, 1996 to 2019: a serial cross-sectional analysis.

作者信息

Levy Adrian R, Stock David, Paterson J Michael, Tamim Hala, Chateau Dan, Quail Jacqueline, Ronksley Paul E, Carney Greg, Reynier Pauline, Targownik Laura

机构信息

Department of Community Health and Epidemiology (Levy, Stock), Dalhousie University, Halifax, NS; ICES (Paterson); York University (Tamim), Toronto, Ont.; National Centre for Epidemiology and Population Health (Chateau), College of Health & Medicine, Australian National University, Canberra, AU; Health Quality Council (Quail), Saskatoon, Sask.; Department of Community Health Sciences (Ronksley), University of Calgary, Calgary, Alta.; Therapeutics Initiative (Carney), University of British Columbia, Vancouver, BC; Lady Davis Institute (Reynier), Jewish General Hospital, Montréal, Que.; Department of Medicine (Targownik), University of Toronto, Toronto, Ont.

出版信息

CMAJ Open. 2023 Nov 7;11(6):E1033-E1040. doi: 10.9778/cmajo.20220131. Print 2023 Nov-Dec.

DOI:10.9778/cmajo.20220131

PMID:37935487

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10635705/

Abstract

BACKGROUND

Ranitidine was the most prescribed histamine-2 receptor antagonist (HRA) in Canada when recalled in 2019 because of potential carcinogenicity. We sought to compare geographic and temporal patterns in use of prescription ranitidine and 3 other HRAs and estimated population exposure to ranitidine in 6 provinces between 1996 and 2019.

METHODS

This population-based serial cross-sectional study used prescription claims for HRAs dispensed from community pharmacies in Nova Scotia, Ontario, Manitoba, Saskatchewan, Alberta and British Columbia. We estimated the period prevalence of ranitidine use per 100 population by province, age category and sex. We estimated exposure to ranitidine between 2015 and 2019 using defined daily doses (DDDs).

RESULTS

Overall, 2.4 million ranitidine prescriptions were dispensed to patients aged 65 years and older, and 1.7 million were dispensed to younger adults. Among older adults, the median period prevalence of ranitidine use among females was 16% (interquartile range [IQR] 13%-27%) higher than among males. Among younger adults, the median prevalence was 50% (IQR 37%-70%) higher among females. Among older adults, between 1996 and 1999, use was highest in Nova Scotia (33%) and Ontario (30%), lower in the prairies (Manitoba [18%], Saskatchewan [26%], Alberta [17%]) and lowest in BC (11%). By 2015-2019, use of ranitidine among older adults dropped by at least 50% in all provinces except BC. We estimate that at least 142 million DDDs of prescribed ranitidine were consumed annually in 6 provinces (2015-2019).

INTERPRETATION

Over the 24-year period in 6 provinces, patients aged 65 years and older were dispensed 2.4 million prescriptions of ranitidine and younger adults were dispensed 1.7 million prescriptions of ranitidine. These estimates of ranitidine exposure can be used for planning studies of cancer risk and identifying target populations for cancer surveillance.

摘要

背景

雷尼替丁在2019年因潜在致癌性被召回时，是加拿大处方量最大的组胺-2受体拮抗剂（HRA）。我们试图比较处方雷尼替丁和其他3种HRA的使用的地理和时间模式，并估计1996年至2019年期间6个省份人群对雷尼替丁的暴露情况。

方法

这项基于人群的系列横断面研究使用了新斯科舍省、安大略省、马尼托巴省、萨斯喀彻温省、艾伯塔省和不列颠哥伦比亚省社区药房发放的HRA处方数据。我们按省份、年龄组和性别估计每100人中雷尼替丁使用的期间患病率。我们使用限定日剂量（DDD）估计2015年至2019年期间对雷尼替丁的暴露情况。

结果

总体而言，65岁及以上患者共获得240万张雷尼替丁处方，年轻成年人获得170万张。在老年人中，女性雷尼替丁使用的期间患病率中位数比男性高16%（四分位间距[IQR]为13%-27%）。在年轻成年人中，女性的患病率中位数比男性高50%（IQR为37%-70%）。在老年人中，1996年至1999年期间，新斯科舍省（33%）和安大略省（30%）的使用率最高，草原省份（马尼托巴省[18%]、萨斯喀彻温省[26%]、艾伯塔省[17%]）较低，不列颠哥伦比亚省（11%）最低。到2015-2019年，除不列颠哥伦比亚省外，所有省份老年人中雷尼替丁的使用率至少下降了50%。我们估计，2015-2019年期间，6个省份每年至少消耗1.42亿DDD的处方雷尼替丁。