Risk of Fractures With Concomitant Use of Calcium Channel Blockers and Selective Serotonin Reuptake Inhibitors.

IF 2.3 4区 医学 Q3 PHARMACOLOGY & PHARMACY
Annals of Pharmacotherapy Pub Date : 2024-09-01 Epub Date: 2023-12-11 DOI:10.1177/10600280231218286
Raj Desai, Steven M Smith, Rajesh Mohandas, Joshua Brown, Haesuk Park
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引用次数: 0

Abstract

Background: Despite their frequent concurrent use, little is known about the concomitant use of calcium channel blockers (CCBs) and selective serotonin reuptake inhibitors (SSRIs) on fracture risk. We compared risk of fractures in patients concomitantly treated with CCBs and SSRIs versus CCB-only users. We compared risk of fractures among concomitant CCB-SSRI users initiating cytochrome P450 3A4 (CYP3A4)-inhibiting SSRIs versus non-CYP3A4 inhibiting SSRIs.

Methods: This retrospective cohort study used IBM MarketScan commercial claims and Medicare Supplemental database (2007-2019). We included adults diagnosed with hypertension and depression, newly initiating SSRIs while being treated with CCBs (ie, concomitant CCB-SSRI users) and those who did not (ie, CCB-only users). Primary outcome was the first occurrence of any fracture. We used stabilized inverse probability of treatment weighting (sIPTW) based on propensity scores to balance baseline risk between groups. Cox proportional hazard regression modeling was used to compare fracture risk.

Results: We identified 191 352 concomitant CCB-SSRI and 956 760 CCB-only users (mean age = 56 years, 50.1% males). After sIPTW, compared with CCB-only users, CCBs-SSRIs users had a higher risk of fractures (hazard ratio [HR]: 1.43, 95% confidence interval [CI]: 1.22-1.66). No difference in the risk of fractures between concomitant users of CCB-CYP3A4-inhibiting SSRIs and those of CCB-non-CYP3A4 inhibiting SSRIs (HR: 1.10, 95% CI: 0.87-1.40) was observed.

Conclusion and relevance: Short-term concomitant CCB-SSRI use was associated with increased fracture risk. Concomitant CCBs and CYP3A4-inhibiting SSRIs compared with CCBs and non-CYP3A4 inhibiting SSRIs use was not associated with increased risk.

同时使用钙通道阻滞剂和选择性羟色胺再摄取抑制剂的骨折风险。
背景:尽管钙通道阻滞剂(CCB)和选择性 5-羟色胺再摄取抑制剂(SSRI)经常同时使用,但人们对它们同时使用对骨折风险的影响知之甚少。我们比较了同时接受 CCB 和 SSRIs 治疗的患者与仅接受 CCB 治疗的患者的骨折风险。我们比较了同时服用细胞色素 P450 3A4 (CYP3A4) 抑制性 SSRI 与非 CYP3A4 抑制性 SSRI 的 CCB-SSRI 患者的骨折风险:这项回顾性队列研究使用了 IBM MarketScan 商业索赔和医疗保险补充数据库(2007-2019 年)。我们纳入了被诊断患有高血压和抑郁症、在接受氯苯类药物治疗时新开始服用 SSRIs 的成人(即同时服用氯苯类药物和 SSRIs 的患者)和未服用 SSRIs 的成人(即仅服用氯苯类药物的患者)。主要结果是首次发生任何骨折。我们使用基于倾向评分的稳定逆治疗概率加权(sIPTW)来平衡各组间的基线风险。采用 Cox 比例危险回归模型比较骨折风险:我们发现了191352名同时服用CCB-SSRI的患者和956760名仅服用CCB的患者(平均年龄=56岁,50.1%为男性)。sIPTW后,与纯CCB使用者相比,CCBs-SSRIs使用者的骨折风险更高(危险比[HR]:1.43,95%置信区间[CI]:1.22-1.66)。同时服用CCB-CYP3A4抑制性SSRIs和服用CCB-非CYP3A4抑制性SSRIs的患者发生骨折的风险没有差异(HR:1.10,95% CI:0.87-1.40):短期同时服用CCB-SSRI与骨折风险增加有关。与同时服用CCBs和非CYP3A4抑制性SSRIs相比,同时服用CCBs和CYP3A4抑制性SSRIs与风险增加无关。
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来源期刊
CiteScore
5.70
自引率
0.00%
发文量
166
审稿时长
3-8 weeks
期刊介绍: Annals of Pharmacotherapy (AOP) is a peer-reviewed journal that advances pharmacotherapy throughout the world by publishing high-quality research and review articles to achieve the most desired health outcomes.The articles provide cutting-edge information about the most efficient, safe and cost-effective pharmacotherapy for the treatment and prevention of various illnesses. This journal is a member of the Committee on Publication Ethics (COPE). Average time from submission to first decision: 14 days
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