Association between domperidone use and adverse cardiovascular events: A nested case-control and case-time-control...

Area of Science:

• Cardiovascular pharmacology
• Drug safety
• Epidemiology

Background:

• Domperidone is a widely used antiemetic and prokinetic agent.
• Concerns exist regarding its potential cardiovascular adverse effects.
• Comparative safety data with other commonly used agents like metoclopramide are limited.

Purpose of the Study:

• To assess the association between domperidone use and adverse cardiovascular events.
• To compare the cardiovascular safety of domperidone with metoclopramide and non-use.

Main Methods:

• Nested case-control and case-time-control studies were conducted using Korea's national healthcare database (2002-2015).
• Patients without prior cardiovascular disease were identified and followed for adverse cardiovascular events (arrhythmia, hypertension, acute myocardial infarction).
• Exposure to domperidone, metoclopramide, or non-use was assessed in the days preceding the event.

Main Results:

• Domperidone use was associated with an increased risk of cardiovascular events compared to non-use (OR 1.38-1.40).
• Conversely, domperidone use showed a reduced risk compared to metoclopramide use (OR 0.63-0.64).
• The risk of myocardial infarction was notably higher with domperidone versus non-use, but not significantly different versus metoclopramide.

Conclusions:

• Findings suggest a positive association between domperidone and adverse cardiovascular events.
• Domperidone may possess a safer cardiovascular risk profile when compared to metoclopramide.
• Further research is warranted to elucidate the precise cardiovascular risks associated with domperidone.