High Risk of Metabolic Side Effects Among New Paediatric Antipsychotic Users in Sweden-A Register-Based Study.

IF 2.6 4区医学 Q3 PHARMACOLOGY & PHARMACY

Pharmacoepidemiology and Drug Safety Pub Date : 2026-10-01 DOI:10.1002/pds.70482

Elin Eyfells Kimland, Anders Sundström, Sverre Wikström, Håkan Jarbin, Elin Dahlén

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引用次数: 0

Abstract

Purpose: This study aims to assess the risk of metabolic side effects among paediatric new users of antipsychotics in Sweden, focusing on differences between substances and sexes.

Methods: Children aged 5-17 years, who were new users of antipsychotics between 2014 and 2021, were identified using Swedish national health registers. Cox' models were fitted for children during first treatment with an antipsychotic, excluding those with eating disorders, yielding hazard ratios (HRs) for metabolic side effects with 95% confidence intervals (CIs).

Results: A total of 5441 children were new users of antipsychotics. Of these, 399 (7.3%; 42% girls) received a new diagnosis or new treatment indicating a metabolic side effect, of which 139 cases during first-line treatment and without an eating disorder diagnosis. Obesity was the most common metabolic side effect, accounting for 69% of the cases. In girls, significantly increased risks were observed for aripiprazole (HR 3.52, 95% CI 1.58-7.80), olanzapine (HR 6.99, 95% CI 2.34-20.93) and quetiapine (HR 4.87, 95% CI 1.97-12.04), compared with risperidone. Younger girls had higher risks. In boys, a significantly increased risk was found for aripiprazole (HR 2.21, 95% CI 1.37-3.56).

Conclusion: The overall risk of metabolic side effects is considerable, with higher relative risks in girls, especially younger girls. These findings highlight the need for carefully considered treatment and attentive monitoring when initiating antipsychotics in children.

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瑞典儿科抗精神病药物新使用者代谢副作用的高风险——一项基于登记的研究

目的：本研究旨在评估瑞典儿科抗精神病药物新使用者的代谢副作用风险，重点关注药物和性别之间的差异。方法：使用瑞典国家健康登记册对2014年至2021年间新使用抗精神病药物的5-17岁儿童进行识别。Cox模型适用于首次接受抗精神病药物治疗的儿童，排除饮食失调的儿童，代谢副作用的风险比（hr）为95%置信区间（CIs）。结果：共有5441名儿童是抗精神病药物的新使用者。其中，399例（7.3%；42%为女孩）接受了新的诊断或新的治疗，表明存在代谢副作用，其中139例在一线治疗期间未被诊断为饮食失调。肥胖是最常见的代谢副作用，占病例的69%。在女孩中，与利培酮相比，阿立哌唑（HR 3.52, 95% CI 1.58-7.80）、奥氮平（HR 6.99, 95% CI 2.34-20.93）和喹硫平（HR 4.87, 95% CI 1.97-12.04）的风险显著增加。年龄较小的女孩患病风险更高。在男孩中，阿立哌唑的风险显著增加（HR 2.21, 95% CI 1.37-3.56）。结论：代谢副作用的总体风险相当大，女孩，尤其是年轻女孩的相对风险更高。这些发现强调了在儿童开始使用抗精神病药物时需要仔细考虑治疗和密切监测。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Pharmacoepidemiology and Drug Safety 医学-药学

CiteScore

4.80

自引率

7.70%

发文量

173

审稿时长

3 months

期刊介绍： The aim of Pharmacoepidemiology and Drug Safety is to provide an international forum for the communication and evaluation of data, methods and opinion in the discipline of pharmacoepidemiology. The Journal publishes peer-reviewed reports of original research, invited reviews and a variety of guest editorials and commentaries embracing scientific, medical, statistical, legal and economic aspects of pharmacoepidemiology and post-marketing surveillance of drug safety. Appropriate material in these categories may also be considered for publication as a Brief Report. Particular areas of interest include: design, analysis, results, and interpretation of studies looking at the benefit or safety of specific pharmaceuticals, biologics, or medical devices, including studies in pharmacovigilance, postmarketing surveillance, pharmacoeconomics, patient safety, molecular pharmacoepidemiology, or any other study within the broad field of pharmacoepidemiology; comparative effectiveness research relating to pharmaceuticals, biologics, and medical devices. Comparative effectiveness research is the generation and synthesis of evidence that compares the benefits and harms of alternative methods to prevent, diagnose, treat, and monitor a clinical condition, as these methods are truly used in the real world; methodologic contributions of relevance to pharmacoepidemiology, whether original contributions, reviews of existing methods, or tutorials for how to apply the methods of pharmacoepidemiology; assessments of harm versus benefit in drug therapy; patterns of drug utilization; relationships between pharmacoepidemiology and the formulation and interpretation of regulatory guidelines; evaluations of risk management plans and programmes relating to pharmaceuticals, biologics and medical devices.