开始服用普雷加巴林与 gabapentin 和心力衰竭的发展
Elizabeth E Park1, Laura L Daniel2, Alyson L Dickson3,4,5,6
1Department of Medicine, Columbia University Irving Medical Center, New York, New York.
JAMA network open
|August 1, 2025
概括
与 gabapentin 用户相比,pregabalin 的新用户患心力衰竭 (HF) 的风险增加. 这种风险在先前患有心血管疾病的患者中更为明显.
科学领域:
- 药理学 药理学是指药理学的学科.
- 心脏病学 心脏病学
- 医疗保健服务研究 医疗服务研究
背景情况:
- 慢性疼痛影响高达30%的患者,而普雷加巴林和 gabapentin 是常见的非阿片类药物治疗方法.
- 与 gabapentin 相比,Pregabalin 与 α2δ 子单元的较高结合亲和力表明可能增加心力衰竭 (HF) 风险.
研究的目的:
- 为了比较医院住院和急诊室 (ED) 访问的心力衰竭 (HF) 的发生率,在新使用普雷加巴林与 gabapentin 之间.
- 评估在医疗保险受益者与非癌症慢性疼痛的Pregabalin和Gabapentin使用和HF风险之间的关联.
主要方法:
- 一项对65-89岁的医疗保险受益者进行的回顾性队列研究,这些受益者患有非癌症慢性疼痛,但不包括以前患有HF或末期疾病的人.
- 确定了新使用普雷加巴林或 gabapentin 的用户,并通过对 231 个共同变量进行倾向评分调整来评估结果.
- 主要结局是因HF入院或ED访问;次要结局包括门诊HF诊断和全因死亡率.
主要成果:
- 该研究包括246,237名受益者,其中有18622名新的普雷加巴林使用者和227,615名新的 gabapentin 使用者.
- 与 gabapentin 用户 (12.5 每 1000 人/年) 相比,新的 普雷加巴林 用户的 HF 住院/ED 访问率 (18.2 每 1000 人/年) 高于 gabapentin 用户 (12.5 每 1000 人/年),调整后危险比率 (AHR) 为 1.48.
- 在患有心血管疾病史 (AHR,1.85) 的患者中,使用普雷加巴林与心血管疾病风险增加有关,门诊心血管疾病发病率增加 (AHR,1.27).
结论:
- 在患有慢性非癌症疼痛的医疗保险受益者中,与 gabapentin 的新用户相比,pregabalin 的新用户心力衰竭 (HF) 的发生率增加.
- 这些发现突显了普雷加巴林可能增加HF风险,特别是在患有心血管疾病的患者中.
- 在处方普雷加巴林与 gabapentin 时,需要考虑 HF 风险,特别是在心血管并发症的患者中.
更多相关视频
07:01Electrophoretic Delivery of γ-aminobutyric Acid GABA into Epileptic Focus Prevents Seizures in Mice
Published on: May 16, 2019
9.1K
10:01High-Throughput Optical Controlling and Recording Calcium Signal in iPSC-Derived Cardiomyocytes for Toxicity Testing and Phenotypic Drug Screening
Published on: March 31, 2022
3.3K
相关概念视频
01:20Antiepileptic Drugs: Potassium Channel Activators
272
Ezocgabine or retigabine, an antiepileptic drug of remarkable efficacy, has revolutionized the management of seizures. It is a potassium channel activator, explicitly targeting the family of Q subtype potassium channels. It enhances the transmembrane potassium currents, regulating neuronal excitability. This action stabilizes the resting membrane potential, a pivotal factor in mitigating the hyperexcitability that characterizes epilepsy.
Ezogabine has gained approval as an adjunctive treatment...
Ezogabine has gained approval as an adjunctive treatment...
272
01:18Antiepileptic Drugs: GABAergic Pathway Potentiators
632
γ-aminobutyric acid or GABA, plays a pivotal role as an inhibitory neurotransmitter in the brain. GABA pathway potentiators, also known as GABAergic drugs, are a class of pharmaceutical agents designed to enhance the functioning of the GABAergic system. These medications primarily treat epilepsy, a neurological disorder characterized by recurrent seizures.
The key GABA pathway potentiators used in epilepsy management are as follows.
Benzodiazepines are a well-known class of drugs used for...
The key GABA pathway potentiators used in epilepsy management are as follows.
Benzodiazepines are a well-known class of drugs used for...
632
01:26Heart Failure Drugs: Inotropic Agents
716
Positive inotropic agents are commonly used as the first line of treatment for heart failure. One such agent is digoxin, derived from the genus Digitalis, which has been known for centuries but effectively utilized since 1785. However, these cardiac glycosides can have potentially toxic effects due to their mechanism of action, which involves inhibiting Na+/K+-ATPase and increasing contractility. Digoxin is absorbed orally and distributed in various tissues, including the CNS. It has a long...
716
01:14Antiepileptic Drugs: Glutamate Antagonists
509
Glutamate is a fundamental neurotransmitter in the central nervous system, playing a vital role in neuronal communication and various cognitive processes. Glutamate stands as the principal excitatory neurotransmitter in the brain. Its presence is crucial for the communication between neurons, underpinning essential processes such as synaptic transmission, neuronal excitability, and plasticity. These functions are vital for higher-order cognitive processes, including learning and memory. The...
509
01:22Antiarrhythmic Drugs: Class I Agents as Sodium Channel Blockers
1.7K
Class I antiarrhythmic drugs are used to treat various types of arrhythmias or irregular heart rhythms. These drugs block the sodium (Na+) channels in the cardiac cells, thereby affecting the movement of electrical impulses across the heart. Class I antiarrhythmic drugs are divided into three subgroups: Class IA, Class IB, and Class IC, each with distinct mechanisms of action and effects on the heart.
Class 1A Antiarrhythmic Drugs: These drugs work by moderately blocking sodium channels,...
Class 1A Antiarrhythmic Drugs: These drugs work by moderately blocking sodium channels,...
1.7K
01:20Antiepileptic Drugs: Modulators of Neurotransmitter Release Mediated by SV2A Protein
439
Antiepileptic drugs, such as levetiracetam (Keppra) and brivaracetam (Briviact), have emerged as crucial tools in managing epilepsy. These medications exert their therapeutic effects by targeting the synaptic vesicle protein SV2A, a transmembrane glycoprotein primarily found in the brain.
SV2A is a transmembrane glycoprotein located predominantly in the brain, modulating the release of neurotransmitters for neuronal communication. Both levetiracetam and brivaracetam exhibit a high affinity for...
SV2A is a transmembrane glycoprotein located predominantly in the brain, modulating the release of neurotransmitters for neuronal communication. Both levetiracetam and brivaracetam exhibit a high affinity for...
439