BACKGROUND: The US Food and Drug Administration has issued safety alerts about leukotriene receptor-modifying agents and suicidality/suicide, but because these were based on case reports, there is controversy about the association. OBJECTIVE: We conducted a nested case-control study to determine the association between leukotriene-modifying agents (LTMAs) and attempted suicide among asthmatic children and young adults. METHODS: Cases and control subjects were from a cohort of asthmatic patients aged 5 to 24 years who were new users of LTMAs or other asthma medications. Data were from an insurance claims database. Cases were defined as those with a suicide attempt (SA) occurring after exposure to asthma medication. Control subjects were persons at risk and were selected by using incidence density sampling in a 10:1 match. Conditional logistic regression was used to determine the association between LTMA exposure and the risk of attempted suicide adjusted for important covariates. RESULTS: We identified 344 cases and 3438 matched control subjects. Cases were more likely than control subjects to have risk factors for suicide. We found that current use of any LTMA was not associated with increased risk of an SA; in fact, the direction of effect was the opposite (adjusted odd ratio, 0.70; 95% CI, 0.36-1.39). CONCLUSION: In this analysis we found that use of LTMAs was not associated with an increased risk of SAs in children, adolescents, and young adults with asthma. Further research needs to be conducted to more fully understand the association between LTMAs and suicide, particularly in subpopulations.
BACKGROUND: The US Food and Drug Administration has issued safety alerts about leukotriene receptor-modifying agents and suicidality/suicide, but because these were based on case reports, there is controversy about the association. OBJECTIVE: We conducted a nested case-control study to determine the association between leukotriene-modifying agents (LTMAs) and attempted suicide among asthmatic children and young adults. METHODS: Cases and control subjects were from a cohort of asthmatic patients aged 5 to 24 years who were new users of LTMAs or other asthma medications. Data were from an insurance claims database. Cases were defined as those with a suicide attempt (SA) occurring after exposure to asthma medication. Control subjects were persons at risk and were selected by using incidence density sampling in a 10:1 match. Conditional logistic regression was used to determine the association between LTMA exposure and the risk of attempted suicide adjusted for important covariates. RESULTS: We identified 344 cases and 3438 matched control subjects. Cases were more likely than control subjects to have risk factors for suicide. We found that current use of any LTMA was not associated with increased risk of an SA; in fact, the direction of effect was the opposite (adjusted odd ratio, 0.70; 95% CI, 0.36-1.39). CONCLUSION: In this analysis we found that use of LTMAs was not associated with an increased risk of SAs in children, adolescents, and young adults with asthma. Further research needs to be conducted to more fully understand the association between LTMAs and suicide, particularly in subpopulations.
Authors: Christine Y Lu; Fang Zhang; Matthew D Lakoma; Melissa G Butler; Vicki Fung; Emma K Larkin; Elyse O Kharbanda; William M Vollmer; Tracy Lieu; Stephen B Soumerai; Ann Chen Wu Journal: Clin Ther Date: 2015-04-25 Impact factor: 3.393
Authors: Mark A Ferro; Anne E Rhodes; Melissa Kimber; Laura Duncan; Michael H Boyle; Katholiki Georgiades; Andrea Gonzalez; Harriet L MacMillan Journal: Can J Psychiatry Date: 2017-08-17 Impact factor: 4.356
Authors: Lutfiyya N Muhammad; Jeffrey E Korte; Charles M Bowman; Mark L De Santis; Paul J Nietert Journal: J Sch Health Date: 2018-10 Impact factor: 2.118
Authors: James S Leung; David W Johnson; Arissa J Sperou; Jennifer Crotts; Erik Saude; Lisa Hartling; Antonia Stang Journal: PLoS One Date: 2017-08-09 Impact factor: 3.240