Polypharmacy Is Associated With Amiodarone-Induced Hypothyroidism.

Area of Science:

• Cardiology
• Endocrinology
• Pharmacology

Background:

• Amiodarone, an antiarrhythmic drug, is rich in iodine and a common cause of amiodarone-induced hypothyroidism (AIH).
• Atrial fibrillation, the most common sustained arrhythmia, is frequently treated with amiodarone.
• Polypharmacy is prevalent in atrial fibrillation patients, increasing the potential for drug-drug interactions.

Purpose of the Study:

• To investigate the association between polypharmacy and the development of amiodarone-induced hypothyroidism (AIH).
• To determine if the number of co-prescribed drugs influences the risk of AIH.

Main Methods:

• Retrospective study using a large prescription database (January 2006 - May 2020).
• Patients were categorized into polypharmacy (≥5 drugs) and non-polypharmacy (<5 drugs) groups.
• Sequence symmetry analysis and a case-control study were performed to assess the association between amiodarone, thyroxine, and polypharmacy.

Main Results:

• Sequence symmetry analysis showed a significant association between amiodarone and thyroxine in both polypharmacy and non-polypharmacy groups.
• The case-control study revealed that polypharmacy (≥5 drugs) significantly increased the odds of developing AIH (OR: 1.48, 95% CI: 1.18-1.84).

Conclusions:

• Polypharmacy is identified as an independent risk factor for amiodarone-induced hypothyroidism (AIH).
• Clinical practice should involve careful assessment of prescription appropriateness in patients taking amiodarone, especially those on multiple medications.