Frida Vilstrup, Pradeesh Sivapalan, Josefin Eklöf, Alexander Jordan, Tor Biering-Sørensen, Søren Sperling, Jens-Ulrik Stæhr Jensen
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A propensity score matched cohort was created by matching the population on known predictors of the outcome, and an unadjusted Cox proportional hazards regression analysis was performed. Lastly, a multivariable Cox analysis was performed on the entire, unmatched population, adjusting for the same variables as used in the propensity matching.</p><p><strong>Results: </strong>The study population consisted of a cohort of 56,691 eligible patients with COPD, of whom 3,139 were exposed to Quinine. The propensity score matching led to two groups of 2,537 COPD patients, where one group was exposed to Quinine (cases) and the other group was not (controls). Exposure to Quinine was associated with an increased risk of exacerbations or death in a sensitivity analysis of the propensity-score-matched population (Hazard Ratio (HR) 1.130, 95% Confidence Interval (CI) 1.03 to 1.24). 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引用次数: 0
摘要
目的:慢性阻塞性肺疾病(COPD)患者是一个严重合并症群体。奎宁常用于治疗不宁腿综合征(RLS),尽管该药物的副作用可能对特定患者群体有害。本研究的目的是确定奎宁治疗与慢性阻塞性肺病患者急性加重和死亡风险之间的关系,这在以前没有研究过。方法:对丹麦国家登记处的数据进行分析,其中包含有关患者及其健康、处方、住院和门诊就诊的信息。通过对已知结果预测因子进行人群匹配,建立倾向评分匹配队列,并进行未调整的Cox比例风险回归分析。最后,对整个未匹配的人口进行多变量Cox分析,调整倾向匹配中使用的相同变量。结果:研究人群包括56,691名符合条件的COPD患者,其中3,139人暴露于奎宁。倾向评分匹配导致两组2537名COPD患者,其中一组暴露于奎宁(病例),另一组不暴露(对照组)。在倾向评分匹配人群的敏感性分析中,暴露于奎宁与加重或死亡风险增加相关(危险比(HR) 1.130, 95%可信区间(CI) 1.03 ~ 1.24)。对未匹配人群的未调整分析显示类似的结果(HR 1.475, 95% CI 1.39至1.56)。结论:在目前的研究中,我们发现慢性阻塞性肺病患者使用奎宁与急性加重和死亡风险增加之间存在关联。对结果的解释必须注意研究的观察性质,为了明确确定两者之间的联系,应该进行进一步的调查。
Quinine Use and the Risk of Exacerbations of Chronic Obstructive Pulmonary Disease: A Nationwide Retrospective Registry Study.
Objective: Patients with chronic obstructive pulmonary disease (COPD) are a heavily comorbid group. Quinine is often used in the treatment of restless leg syndrome (RLS), although the adverse effects of the drug may be harmful for specific patient groups. The aim of this study was to determine the association between treatment with Quinine and the risk of acute exacerbations and mortality in patients with COPD, which has not previously been investigated.
Methods: Analyses were performed on data from Danish national registries containing information about the relevant patients and their health, prescriptions, hospital admissions, and outpatient clinic visits. A propensity score matched cohort was created by matching the population on known predictors of the outcome, and an unadjusted Cox proportional hazards regression analysis was performed. Lastly, a multivariable Cox analysis was performed on the entire, unmatched population, adjusting for the same variables as used in the propensity matching.
Results: The study population consisted of a cohort of 56,691 eligible patients with COPD, of whom 3,139 were exposed to Quinine. The propensity score matching led to two groups of 2,537 COPD patients, where one group was exposed to Quinine (cases) and the other group was not (controls). Exposure to Quinine was associated with an increased risk of exacerbations or death in a sensitivity analysis of the propensity-score-matched population (Hazard Ratio (HR) 1.130, 95% Confidence Interval (CI) 1.03 to 1.24). An unadjusted analysis on the unmatched population showed similar results (HR 1.475, 95% CI 1.39 to 1.56).
Conclusion: In the current study, we found an association between the use of Quinine in patients with COPD and an increased risk of acute exacerbations and death. The results must be interpreted with attention to the observational nature of the study, and in order to definitively determine the association, further investigations should be performed.
期刊介绍:
An international, peer-reviewed journal of therapeutics and pharmacology focusing on concise rapid reporting of clinical studies and reviews in COPD. Special focus will be given to the pathophysiological processes underlying the disease, intervention programs, patient focused education, and self management protocols. This journal is directed at specialists and healthcare professionals