1996年至2019年加拿大6个省的处方雷尼替丁使用和人群暴露:一项系列横断面分析。

CMAJ open Pub Date : 2023-11-07 Print Date: 2023-11-01 DOI:10.9778/cmajo.20220131
Adrian R Levy, David Stock, J Michael Paterson, Hala Tamim, Dan Chateau, Jacqueline Quail, Paul E Ronksley, Greg Carney, Pauline Reynier, Laura Targownik
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引用次数: 0

摘要

背景:雷尼替丁是加拿大处方最多的组胺-2受体拮抗剂(H2RA),因其潜在致癌性于2019年被召回。我们试图比较1996年至2019年间6个省处方雷尼替丁和其他3种HRA的使用的地理和时间模式,以及估计人群对雷尼替丁的接触情况。方法:这项基于人群的系列横断面研究使用了新斯科舍省、安大略省、曼尼托巴省、萨斯喀彻温省、,阿尔伯塔省和不列颠哥伦比亚省。我们估计了按省份、年龄类别和性别划分的每100人中雷尼替丁使用的时期流行率。我们使用限定日剂量(DDDs)估计了2015年至2019年期间雷尼替丁的暴露量。结果:总体而言,240万份雷尼替丁处方被分配给65岁及以上的患者,170万份被分配给年轻人。在老年人中,女性使用雷尼替丁的中位患病率比男性高16%(四分位间距[IQR]13%-27%)。在年轻人中,女性的中位患病率高出50%(IQR 37%-70%)。在老年人中,1996年至1999年间,新斯科舍省(33%)和安大略省(30%)的使用率最高,大草原地区(马尼托巴省[18%]、萨斯喀彻温省[26%]、阿尔伯塔省[17%])的使用量较低,不列颠哥伦比亚省最低(11%)。截至2015-2019年,除不列颠哥伦比亚省外,所有省份的老年人雷尼替丁使用量都下降了至少50%。我们估计,6个省(2015-2019年)每年至少消耗1.42亿个处方雷尼替丁的限定日剂量。解释:在6个省的24年期间,65岁及以上的患者服用了240万个雷尼替丁处方,年轻人服用了170万个雷尼替丁处方。这些雷尼替丁暴露量的估计可用于规划癌症风险研究和确定癌症监测的目标人群。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Prescription ranitidine use and population exposure in 6 Canadian provinces, 1996 to 2019: a serial cross-sectional analysis.

Background: Ranitidine was the most prescribed histamine-2 receptor antagonist (H2RA) in Canada when recalled in 2019 because of potential carcinogenicity. We sought to compare geographic and temporal patterns in use of prescription ranitidine and 3 other HRAs and estimated population exposure to ranitidine in 6 provinces between 1996 and 2019.

Methods: This population-based serial cross-sectional study used prescription claims for H2RAs dispensed from community pharmacies in Nova Scotia, Ontario, Manitoba, Saskatchewan, Alberta and British Columbia. We estimated the period prevalence of ranitidine use per 100 population by province, age category and sex. We estimated exposure to ranitidine between 2015 and 2019 using defined daily doses (DDDs).

Results: Overall, 2.4 million ranitidine prescriptions were dispensed to patients aged 65 years and older, and 1.7 million were dispensed to younger adults. Among older adults, the median period prevalence of ranitidine use among females was 16% (interquartile range [IQR] 13%-27%) higher than among males. Among younger adults, the median prevalence was 50% (IQR 37%-70%) higher among females. Among older adults, between 1996 and 1999, use was highest in Nova Scotia (33%) and Ontario (30%), lower in the prairies (Manitoba [18%], Saskatchewan [26%], Alberta [17%]) and lowest in BC (11%). By 2015-2019, use of ranitidine among older adults dropped by at least 50% in all provinces except BC. We estimate that at least 142 million DDDs of prescribed ranitidine were consumed annually in 6 provinces (2015-2019).

Interpretation: Over the 24-year period in 6 provinces, patients aged 65 years and older were dispensed 2.4 million prescriptions of ranitidine and younger adults were dispensed 1.7 million prescriptions of ranitidine. These estimates of ranitidine exposure can be used for planning studies of cancer risk and identifying target populations for cancer surveillance.

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