Edeltraut Kröger1, Rob Van Marum, Patrick Souverein, Pierre-Hugues Carmichael, Toine Egberts. 1. Centre d'excellence sur le vieillissement de Québec, Centre de recherche du CHU de Québec, Québec, Canada; Utrecht University, Division of Pharmacoepidemiology and Pharmacotherapy, Utrecht Institute for Pharmaceutical Sciences, Utrecht, the Netherlands.
Abstract
BACKGROUND: Treatment of Alzheimer disease (AD) with cholinesterase inhibitors (ChEIs) may increase the risk of urinary incontinence (UI). OBJECTIVE: To assess whether ChEI use was associated with the risk of UI among older patients with AD. METHODS: A crossover cohort study using the PHARMO Record Linkage System included 10 years of data on drug dispensing histories for over two million Dutch residents. Included patients were aged 50 +, free of UI for the last 6 months, received a first ChEI prescription during the study period, had at least 12 months prior drug exposure history and one subsequent prescription of any drug. UI was defined as a first dispensing of a urinary spasmolytic or of incontinence products for at least 30 days. Cox regression with time-varying covariates and multivariate adjustment allowed assessing whether UI incidence was associated with ChEI exposure. RESULTS: Among 3154 patients there were 657 UI cases during a mean follow-up of 5.1 years before a first ChEI dispensing, and 499 cases after ChEI initiation, during a mean follow-up of 2.0 years. Among the 2700 participants free of UI one year before ChEI initiation, the adjusted hazard ratio (HR) for UI was 1.13 (95% CI: 0.97-1.32) when periods with ChEI use were compared to periods without ChEI use. Sensitivity analyses may suggest an increased risk in the 1(st) month after ChEI initiation (HR: 1.72, p = 0.09) CONCLUSION: Worsening AD may increase incidence of UI, but no firm association between ChEI treatment and risk of UI could be shown from these data.
BACKGROUND: Treatment of Alzheimer disease (AD) with cholinesterase inhibitors (ChEIs) may increase the risk of urinary incontinence (UI). OBJECTIVE: To assess whether ChEI use was associated with the risk of UI among older patients with AD. METHODS: A crossover cohort study using the PHARMO Record Linkage System included 10 years of data on drug dispensing histories for over two million Dutch residents. Included patients were aged 50 +, free of UI for the last 6 months, received a first ChEI prescription during the study period, had at least 12 months prior drug exposure history and one subsequent prescription of any drug. UI was defined as a first dispensing of a urinary spasmolytic or of incontinence products for at least 30 days. Cox regression with time-varying covariates and multivariate adjustment allowed assessing whether UI incidence was associated with ChEI exposure. RESULTS: Among 3154 patients there were 657 UI cases during a mean follow-up of 5.1 years before a first ChEI dispensing, and 499 cases after ChEI initiation, during a mean follow-up of 2.0 years. Among the 2700 participants free of UI one year before ChEI initiation, the adjusted hazard ratio (HR) for UI was 1.13 (95% CI: 0.97-1.32) when periods with ChEI use were compared to periods without ChEI use. Sensitivity analyses may suggest an increased risk in the 1(st) month after ChEI initiation (HR: 1.72, p = 0.09) CONCLUSION: Worsening AD may increase incidence of UI, but no firm association between ChEI treatment and risk of UI could be shown from these data.
Authors: Ann S Doherty; Faiza Shahid; Frank Moriarty; Fiona Boland; Barbara Clyne; Tobias Dreischulte; Tom Fahey; Seán P Kennelly; Emma Wallace Journal: Pharmacol Res Perspect Date: 2022-10
Authors: Lars Wallentin; Folkert W Asselbergs; Riyaz S Patel; Bakhtawar K Mahmoodi; Vinicius Tragante; Marcus E Kleber; Michael V Holmes; Amand F Schmidt; Raymond O McCubrey; Laurence J Howe; Kenan Direk; Hooman Allayee; Ekaterina V Baranova; Peter S Braund; Graciela E Delgado; Niclas Eriksson; Crystel M Gijsberts; Yan Gong; Jaana Hartiala; Mahyar Heydarpour; Gerard Pasterkamp; Salma Kotti; Pekka Kuukasjärvi; Petra A Lenzini; Daniel Levin; Leo-Pekka Lyytikäinen; Jochen D Muehlschlegel; Christopher P Nelson; Kjell Nikus; Anna P Pilbrow; W H Wilson Tang; Sander W van der Laan; Jessica van Setten; Ragnar O Vilmundarson; John Deanfield; Panos Deloukas; Frank Dudbridge; Stefan James; Ify R Mordi; Andrej Teren; Thomas O Bergmeijer; Simon C Body; Michiel Bots; Ralph Burkhardt; Rhonda M Cooper-DeHoff; Sharon Cresci; Nicolas Danchin; Robert N Doughty; Diederick E Grobbee; Emil Hagström; Stanley L Hazen; Claes Held; Imo E Hoefer; G Kees Hovingh; Julie A Johnson; Marcin P Kaczor; Mika Kähönen; Olaf H Klungel; Jari O Laurikka; Terho Lehtimäki; Anke H Maitland-van der Zee; Ruth McPherson; Colin N Palmer; Adriaan O Kraaijeveld; Carl J Pepine; Marek Sanak; Naveed Sattar; Markus Scholz; Tabassome Simon; John A Spertus; Alexandre F R Stewart; Wojciech Szczeklik; Joachim Thiery; Frank L J Visseren; Johannes Waltenberger; A Mark Richards; Chim C Lang; Vicky A Cameron; Axel Åkerblom; Guillaume Pare; Winfried März; Nilesh J Samani; Aroon D Hingorani; Jurriën M Ten Berg Journal: Circulation Date: 2020-07-13 Impact factor: 29.690