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The role of leukotriene modifying agent treatment in neuropsychiatric events of elderly asthma patients: a nested case control study

BACKGROUND: In March 2020, the US Food and Drug Administration decided that the dangers related to neuropsychiatric events (NPEs) of montelukast, one of the leukotriene modifying agents (LTMAs), should be communicated through ‘boxed warning’. In case of NPEs, the prevalence has been the highest in e...

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Autores principales: Kang, Sang Oh, Min, Kyung Hyun, Kim, Hyun Jeong, Kim, Tae Hyeok, Kim, Woorim, Lee, Kyung Eun
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7972201/
https://www.ncbi.nlm.nih.gov/pubmed/33731203
http://dx.doi.org/10.1186/s40733-021-00070-4
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author Kang, Sang Oh
Min, Kyung Hyun
Kim, Hyun Jeong
Kim, Tae Hyeok
Kim, Woorim
Lee, Kyung Eun
author_facet Kang, Sang Oh
Min, Kyung Hyun
Kim, Hyun Jeong
Kim, Tae Hyeok
Kim, Woorim
Lee, Kyung Eun
author_sort Kang, Sang Oh
collection PubMed
description BACKGROUND: In March 2020, the US Food and Drug Administration decided that the dangers related to neuropsychiatric events (NPEs) of montelukast, one of the leukotriene modifying agents (LTMAs), should be communicated through ‘boxed warning’. In case of NPEs, the prevalence has been the highest in elderly people. Because the characteristics of the elderly such as old age itself can act as risk factors. Therefore, an investigation on safety of LTMAs related to NPEs in elderly using LTMAs is needed. METHOD: A nested case-control study using an elderly sample cohort from the Korean National Health Insurance Service database was used. The asthma cohort included asthma patients newly diagnosed between 2003 and 2013. Within the asthma cohort, the case group was defined as patients who were diagnosed with NPEs. Among patients who had never been diagnosed with NPEs, the control group was selected by matching 1:1 by propensity score. Patients who were prescribed LTMAs for 1 year prior to index date were defined as the exposure group. The logistic regression model was used to measure the effect of LTMAs on NPEs. RESULTS: We identified 141,165 patients with newly diagnosed asthma, and selected 31,992 patients per each case and control group. Exposure to LTMAs significantly increased the risk of overall NPEs about in comparison with the absence of exposure (crude odds ratio [OR] 1.58, 95% CI 1.50–1.68). After adjusting for confounding factors, the overall NPEs risk increased (adjusted OR, 1.67, 95% CI 1.58–1.78). CONCLUSION: This study suggests that elderly asthma patients prescribed LTMAs had a higher risk of NPEs than patients who were not treated with LTMAs. Therefore, clinicians should be aware of the potential risks of LTMAs.
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spelling pubmed-79722012021-03-19 The role of leukotriene modifying agent treatment in neuropsychiatric events of elderly asthma patients: a nested case control study Kang, Sang Oh Min, Kyung Hyun Kim, Hyun Jeong Kim, Tae Hyeok Kim, Woorim Lee, Kyung Eun Asthma Res Pract Research BACKGROUND: In March 2020, the US Food and Drug Administration decided that the dangers related to neuropsychiatric events (NPEs) of montelukast, one of the leukotriene modifying agents (LTMAs), should be communicated through ‘boxed warning’. In case of NPEs, the prevalence has been the highest in elderly people. Because the characteristics of the elderly such as old age itself can act as risk factors. Therefore, an investigation on safety of LTMAs related to NPEs in elderly using LTMAs is needed. METHOD: A nested case-control study using an elderly sample cohort from the Korean National Health Insurance Service database was used. The asthma cohort included asthma patients newly diagnosed between 2003 and 2013. Within the asthma cohort, the case group was defined as patients who were diagnosed with NPEs. Among patients who had never been diagnosed with NPEs, the control group was selected by matching 1:1 by propensity score. Patients who were prescribed LTMAs for 1 year prior to index date were defined as the exposure group. The logistic regression model was used to measure the effect of LTMAs on NPEs. RESULTS: We identified 141,165 patients with newly diagnosed asthma, and selected 31,992 patients per each case and control group. Exposure to LTMAs significantly increased the risk of overall NPEs about in comparison with the absence of exposure (crude odds ratio [OR] 1.58, 95% CI 1.50–1.68). After adjusting for confounding factors, the overall NPEs risk increased (adjusted OR, 1.67, 95% CI 1.58–1.78). CONCLUSION: This study suggests that elderly asthma patients prescribed LTMAs had a higher risk of NPEs than patients who were not treated with LTMAs. Therefore, clinicians should be aware of the potential risks of LTMAs. BioMed Central 2021-03-17 /pmc/articles/PMC7972201/ /pubmed/33731203 http://dx.doi.org/10.1186/s40733-021-00070-4 Text en © The Author(s) 2021 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Kang, Sang Oh
Min, Kyung Hyun
Kim, Hyun Jeong
Kim, Tae Hyeok
Kim, Woorim
Lee, Kyung Eun
The role of leukotriene modifying agent treatment in neuropsychiatric events of elderly asthma patients: a nested case control study
title The role of leukotriene modifying agent treatment in neuropsychiatric events of elderly asthma patients: a nested case control study
title_full The role of leukotriene modifying agent treatment in neuropsychiatric events of elderly asthma patients: a nested case control study
title_fullStr The role of leukotriene modifying agent treatment in neuropsychiatric events of elderly asthma patients: a nested case control study
title_full_unstemmed The role of leukotriene modifying agent treatment in neuropsychiatric events of elderly asthma patients: a nested case control study
title_short The role of leukotriene modifying agent treatment in neuropsychiatric events of elderly asthma patients: a nested case control study
title_sort role of leukotriene modifying agent treatment in neuropsychiatric events of elderly asthma patients: a nested case control study
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7972201/
https://www.ncbi.nlm.nih.gov/pubmed/33731203
http://dx.doi.org/10.1186/s40733-021-00070-4
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