Jo Young-Woo, Kwon Hyouk-Soo, Min Joonhong, Her Young, Kwon Jae-Woo
Department of Economics and Statistics, Korea University, Sejong, Korea.
Department of Allergy and Clinical Immunology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
J Allergy Clin Immunol Pract. 2025 Apr;13(4):893-902. doi: 10.1016/j.jaip.2024.09.010. Epub 2024 Sep 17.
Epidemiological studies of neuropsychiatric events (NPEs) associated with leukotriene receptor antagonists (LTRAs) have yielded inconsistent results. Recent studies have demonstrated strong temporal relationships between LTRA prescription and NPE occurrence, indicating a need for further investigation.
To investigate potential LTRA-related NPEs and associated risk factors.
Adults with asthma or rhinitis were enrolled from the Korean claims database. The temporal relationship between the first NPE diagnosis and the last LTRA prescription before NPE was evaluated. Nested case-control studies for NPEs and suicide were conducted. Cases (those with NPEs) were matched to controls for age and sex to compare the frequency of LTRA prescription in the lag time before NPE diagnosis. The risk factors for LTRA-related NPEs (developed within 6 months of LTRA prescription) were assessed in people on LTRAs by comparing those with LTRA-related NPEs to those on LTRAs who did not have NPEs.
Montelukast and pranlukast were more frequently prescribed within 6 months before NPEs (odds ratio, 1.31, 95% CI, 1.21-1.41, and odds ratio, 1.25, 95% CI, 1.15-1.35). Older adults, low income, high comorbidity burden, and asthma exhibited stronger associations with LTRA-related NPEs than with general NPEs. Sleep disturbances appeared more prevalent in LTRA-related NPEs than in other NPEs. An LTRA prescription within 6 months was associated with suicide in univariate but not in multivariate analysis.
Increased neuropsychiatric risk was observed within 6 months after LTRA prescription. LTRA may lower the threshold for NPEs in those at risk for NPEs, irrespective of sex.
与白三烯受体拮抗剂（LTRA）相关的神经精神事件（NPE）的流行病学研究结果并不一致。近期研究表明LTRA处方与NPE发生之间存在密切的时间关系，这表明需要进一步调查。
调查潜在的与LTRA相关的NPE及其相关危险因素。
从韩国索赔数据库中纳入患有哮喘或鼻炎的成年人。评估首次NPE诊断与NPE发生前最后一次LTRA处方之间的时间关系。对NPE和自杀进行巢式病例对照研究。病例（患有NPE的患者）与年龄和性别匹配的对照进行比较，以比较NPE诊断前延迟期内LTRA处方的频率。通过将患有LTRA相关NPE的患者与未患有NPE的LTRA使用者进行比较，评估LTRA相关NPE（在LTRA处方后6个月内发生）的危险因素。
孟鲁司特和普仑司特在NPE发生前6个月内的处方频率更高（比值比分别为1.31，95%置信区间为1.21 - 1.41；以及比值比为1.25，95%置信区间为1.15 - 1.35）。与一般NPE相比，老年人、低收入、高合并症负担和哮喘与LTRA相关NPE的关联更强。睡眠障碍在LTRA相关NPE中似乎比在其他NPE中更普遍。在单变量分析中，6个月内的LTRA处方与自杀有关，但在多变量分析中无关。
在LTRA处方后6个月内观察到神经精神风险增加。LTRA可能会降低有NPE风险人群发生NPE的阈值，与性别无关。
