膀药物和痴呆风险:丹麦全国活跃比较研究
Nelsan Pourhadi1, Janet Janbek1, Christiane Gasse2,3
1Danish Dementia Research Centre, Department of Neurology, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark.
BMJ medicine
|March 6, 2025
概括
与不使用相比,抗胆固醇膀药物增加痴呆症风险. 然而,与乙3激动性膀药物mirabegron相比,没有观察到这种风险,这凸显了研究中活性对比剂的重要性.
科学领域:
- 老年学是指老年学的学科.
- 药理学 药理学是指药理学的学科.
- 神经学 神经学
背景情况:
- 过度活性膀 (OAB) 在老年人中很常见.
- 抗胆固醇药物经常被处方用于OAB.
- 人们对抗胆固醇药物的潜在认知副作用存在担忧.
研究的目的:
- 调查抗胆固醇膀药物的累积使用与所有原因痴呆症风险之间的关联.
- 为了比较这种风险与不使用和使用mirabegron,一种β3激动性膀药物的风险.
主要方法:
- 一项丹麦全国性嵌套病例控制研究,使用2000-2022年的注册表数据.
- 包括226万个年龄在60-75岁的人,与痴呆病例和对照组相匹配.
- 通过填写的处方和定义的每日剂量来评估药物使用;根据并发病和教育进行调整.
主要成果:
- 曾经使用过抗胆固醇膀药物与44%的痴呆风险增加有关,而非使用 (IRR 1.44,95% CI 1.40-1.48).
- 风险随着累积使用而增加,达到1.68的IRR>365定义的每日剂量.
- 在比较抗胆固醇药物的使用与mirabegron的使用时,没有发现痴呆症风险增加 (IRR 0.82,95% CI 0.74-0.92).
结论:
- 与不使用相比,抗胆固醇膀药物与痴呆症风险增加有关.
- 使用mirabegron作为一个活跃的比较物否定了这种观察到的风险.
- 强调了药物安全研究中活跃比较器的重要性,并建议进一步调查认知风险.
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