低剂量奎平对老年人失眠的安全性
Rita L Hui1, Ashley L Lee2, Eric A Lee3
1Pharmacy Outcomes Research Group, Kaiser Permanente, Oakland, CA, USA.
Drugs & aging
|January 3, 2025
概括
与特拉佐相比,老年人对失眠的低剂量奎蒂阿平的使用与死亡率,痴呆和跌倒的增加有关. 它还显示出与米尔塔沙相比,痴呆症风险更高,需要谨慎.
科学领域:
- 老年医学 老年医学
- 药理学 药理学是指药理学的学科.
- 临床安全 临床安全
背景情况:
- 低剂量奎平用于老年人失眠,尽管FDA批准其作为抗精神病药物.
- 标准提剂量与痴呆症患者的不良事件有关,但老年人低剂量安全性数据有限.
研究的目的:
- 为了比较低剂量奎蒂亚平与特拉佐或米尔塔扎平在老年人失眠治疗中的安全性.
- 评估与这些失眠药物相关的死亡,中风,痴呆和跌倒的风险.
主要方法:
- 对65岁以上患者进行回顾性队列研究,开始低剂量治疗失眠的奎蒂亚平,特拉佐或米尔塔扎.
- 倾向性得分匹配 (4:1比) 用于比较药物组之间的结果.
- 随访包括死亡率,中风,痴呆和跌倒的新诊断,数据从2018年10月到2022年9月.
主要成果:
- 奎蒂阿平组 (n=375) 显示死亡率增加 (HR 3.1),痴呆症 (HR 8.1) 和跌倒 (HR 2.8) 与特拉佐 (n=1500) 相比.
- 通过比较奎蒂亚平与米尔塔扎平 (n=1500),奎蒂亚平的使用与更高的痴呆风险有关 (HR 7.1).
- 对于其他次要结果,没有发现显著差异.
结论:
- 在老年人中治疗失眠的低剂量奎蒂亚平存在重大安全问题.
- 与特拉佐和米尔塔扎相比,在这种人群中为失眠处方奎蒂亚平需要仔细考虑,因为死亡,痴呆和跌倒的风险较高.
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