Medication-induced SIADH: distribution and characterization according to medication class

AbstractBackgroundAntihypertensives are the most used medication type in the United States, yet there remains uncertainty about the use of different antihypertensives. We sought to characterize use of antihypertensives by and within medication class(es) between 1997-2017.MethodsA repeated cross-sectional study of 493,596 adult individuals using the 1997-2017 Medical Expenditure Panel Survey (MEPS). The Orange Book and published research were used for adjunctive information. The primary outcome was the estimated use by and within anti-hypertensive medication class(es).ResultsThe proportion of individuals taking any antihypertensive during a year increased from 1997 to the early 2010’s and then remained stable. The proportion of the population taking 2 or more medications declined from 2015-2017. The proportion of adults using angiotensin II receptor-blockers (ARBs) and dihydropyridine calcium channel-blockers (CCBs) increased during the study period, while angiotensin-converting enzyme inhibitors (ACE-Is) increased until 2010 after which rates remained stable. Beta-blocker use was similar to ACE-Is with an earlier decline starting in 2012. Thiazide diuretic use increased from 1997-2007, leveled off until 2014, and declined from 2015-2017. Non-dihydropyridine CCBs use declined throughout the study. ACE-Is, ARBs, CCBs, thiazide diuretics, and loop diuretics all had one dominant in-class medication. There was a clear increase in the use of losartan within ARBs, lisinopril within ACE-Is, and amlodipine within CCBs following generic conversion. Furosemide and hydrochlorothiazide started with and maintained a dominant position in their classes. Metoprolol use increased throughout the study and became the dominant beta-blocker, while atenolol peaked around 2005 and then declined thereafter.ConclusionsAntihypertensive classes appear to have a propensity to equilibrate to an individual medication, despite a lack of outcomes based research to compare medications within a class. Future research could focus on comparative effectiveness for within-class medications early in the life cycle of therapeutics that are probable to have wide spread use.

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Adherence to and Persistence with Antidepressant Medication during Pregnancy: Does It Differ by the Class of Antidepressant Medication Prescribed?

The Canadian Journal of Psychiatry ◽

10.1177/0706743718802809 ◽

2018 ◽

Vol 64 (3) ◽

pp. 199-208 ◽

Cited By ~ 3

Author(s):

Kamala Adhikari ◽

Scott B. Patten ◽

Sangmin Lee ◽

Amy Metcalfe

Keyword(s):

Selective Serotonin Reuptake Inhibitors ◽

Antidepressant Medication ◽

Medication Possession Ratio ◽

Depression Symptoms ◽

Chi Square ◽

Medication Class ◽

Outpatient Physician ◽

Prescription Refill ◽

Atypical Antidepressants ◽

The Impact

Objective: Pregnant women are often concerned about the impact of medication use on their pregnancy, such as congenital abnormalities. This study examined the rate of adherence to and persistence with antidepressant medications during pregnancy based on the class of antidepressants prescribed. Methods: Women who gave birth between 2012 and 2015 in Alberta, Canada; had ≥1 diagnosis of depression within 1 year of preconception in outpatient physician claims, emergency department, or hospitalization administrative data; and were adherent (medication possession ratio ≥80%) to ≥2 consecutive antidepressant prescriptions during the preconception year ( n = 1865) were included in this retrospective cohort study. The rates of adherence and persistence (prescription refill gap ≤30 days) were calculated by antidepressant class and were compared using chi-square tests. Results: During pregnancy, 834 (44.7%; 95% CI, 42.4% to 47.0%) women discontinued antidepressants. Among those continuing antidepressants, the overall rate of adherence was 62.6% (95% CI, 59.4% to 65.7%). The rate differed significantly by medication class ( P < 0.0001), with a rate of 75.1% (95% CI, 68.3% to 80.9%) for serotonin-norepinephrine inhibitors, 60.9% (95% CI, 57.2% to 64.5%) for selective serotonin reuptake inhibitors, 42.8% (95% CI, 19.9% to 69.3%) for nonselective monoamine reuptake inhibitors, and 37.5% (95% CI, 22.5% to 55.4%) for atypical antidepressants. Only, 40.7% (95% CI, 37.5 to 44.1) of women were persistent with antidepressants for the full pregnancy period—the rate differed significantly by medication class ( P < 0.0001). Conclusions: Adherence to and persistence with antidepressants is low during pregnancy and varies by medication class. Low adherence and persistence can interfere with a therapeutic effect of antidepressants, which may contribute to the worsening of depression symptoms.

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P.033 Eptinezumab reduced acute medication use in patients with chronic migraine and medication-overuse headache: subgroup analysis of Promise-2

Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques ◽

10.1017/cjn.2021.315 ◽

2021 ◽

Vol 48 (s3) ◽

pp. S29-S29

Author(s):

MJ Marmura ◽

H Diener ◽

J Hirman ◽

R Cady ◽

T Brevig ◽

...

Keyword(s):

Chronic Migraine ◽

Medication Overuse ◽

Medication Overuse Headache ◽

Baseline Period ◽

Migraine Treatment ◽

Medication History ◽

Medication Class ◽

The Us ◽

Acute Headache ◽

The Impact

Background: Eptinezumab is a preventive migraine treatment approved in the US. We evaluated the impact of eptinezumab on acute headache medication (AHM) use in patients diagnosed with chronic migraine (CM) and medication-overuse headache (MOH) in PROMISE-2. Methods: PROMISE-2 randomized patients with CM to eptinezumab 100mg, 300mg, or placebo for 2 intravenous doses administered every 12 weeks. Trained investigators diagnosed MOH at screening using 3-month medication history and ICHD-3b criteria. Endpoints included days/month of any AHM use (days of ≥1 medication class), total AHM use (summed days for each medication class), and triptan use over Weeks 1-12 and 13-24. AHM classes included triptan, ergot, opioid, simple analgesic, and combination analgesic. Results: Of 1072 PROMISE-2 patients, 431 (40.2%) were diagnosed with MOH (100mg, n=139; 300mg, n=147; placebo, n=145). During the 28-day baseline period, mean days of any AHM was ~16.4, total AHM was ~20.4, and triptan was ~8.9 across treatment arms. Over Weeks 1-12, mean days/month of any AHM was 8.8 (100mg), 9.9 (300mg), and 11.8 (placebo); total AHM was 10.8, 12.2, and 14.8; triptan was 4.3, 4.4, and 6.4. Similar or lower rates were observed over Weeks 13-24. Conclusions: In patients diagnosed with both CM and MOH, eptinezumab treatment reduced AHM use.

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Preferences for Attributes of Medications among Patients with Type 2 Diabetes: A Cross-Medication Class Comparison of Injection Therapies

Current Research in Diabetes & Obesity Journal ◽

10.19080/crdoj.2018.06.555700 ◽

2018 ◽

Vol 6 (5) ◽

Author(s):

Jiat Ling Poon

Keyword(s):

Type 2 Diabetes ◽

Medication Class ◽

Class Comparison

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SP742TIME TO RECOVERY FROM HAEMODIALYSIS-ASSOCIATION WITH MEDICATION CLASS AND PILL BURDEN

Nephrology Dialysis Transplantation ◽

10.1093/ndt/gfv200.61 ◽

2015 ◽

Vol 30 (suppl_3) ◽

pp. iii623-iii623

Author(s):

Anuradha Jayanti ◽

Philip Foden ◽

Sandip Mitra

Keyword(s):

Pill Burden ◽

Medication Class

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Improved reduction of cardiovascular risk by bedtime ingestion of ARB and ACEI medication class therapies

European Heart Journal ◽

10.1093/eurheartj/ehaa214 ◽

2020 ◽

Cited By ~ 2

Author(s):

Ramón C Hermida ◽

Juan J Crespo ◽

Manuel Domínguez-Sardiña

Keyword(s):

Cardiovascular Risk ◽

Medication Class

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Abstract P101: The Association of Hypertension and Antihypertension Medication Use with Sexual Health: A Study from the National Social Health and Aging Project (NSHAP)

Circulation Cardiovascular Quality and Outcomes ◽

10.1161/circoutcomes.4.suppl_2.ap101 ◽

2011 ◽

Vol 4 (suppl_2) ◽

Author(s):

Erica S Spatz ◽

Maureen E Canavan ◽

Mayur M Desai ◽

Harlan M Krumholz ◽

Stacy T Lindau

Keyword(s):

Sexual Health ◽

Sexual Activity ◽

Beta Blockers ◽

Angiotensin Receptor Blockers ◽

Sexual Problems ◽

Self Report ◽

Partner Status ◽

Medication Class ◽

Receptor Blockers ◽

Nationally Representative

Background Hypertension (HTN) and its treatment are commonly associated with sexual problems; yet, data are discordant in men and lacking in women. We investigated the association of HTN and its treatment with sexual health in older adults, and whether the association varied by gender and medication class. Methods Data are from the NSHAP, a nationally-representative observational study of men and women aged 57-85 yrs. Adults were stratified by HTN status: No HTN; HTN-Treated; and HTN-Untreated. HTN was defined by self-report or a mean blood pressure ≥140/90mmHg. HTN-Treated adults reported taking ≥1 of the following medications: diuretics, beta-blockers, calcium-channel blocker, ACE inhibitors or angiotensin receptor blockers, and alpha blockers. We report the prevalence of partnered sexual activity and problems by HTN status. Models testing the association of medication class were examined, stratified by gender, and adjusted for other antihypertensive medication classes (Model 1), and Model 1 plus age, partner status, insurance, diabetes, heart disease, smoking, and functional status (Model 2). Results Comparing HTN-treated to HTN-Untreated and No HTN, the prevalence of sexual activity in men was 60.7% v. 74.3% v. 71.5% (p=.002) and in women 35.4% v. 38.3% v. 58.0% (p<.001). The prevalence of sexual problems in men was 69.3% v. 53.8% v. 51.4% (p=.005) and in women 73.9% v. 66.7% v. 71.7% (p=.367). Most commonly cited were erectile problems (41%) in men with HTN. Diuretics (unadjusted: OR=0.68, p 0.02; Model 1: OR=0.69, p=.03; Model 2: OR=0.72, p=.17) and beta blockers (unadjusted: OR=0.69, p 0.02; Model 1: OR=0.67, p=.03; Model 2: OR=0.79, p=.33) were associated with sexual inactivity in men with treated HTN; diuretics, only, were associated with sexual inactivity in women (unadjusted: OR=0.81, p 0.25; Model 1: OR=0.76, p=.14; Model 2: OR=0.58, p=.02). There were no significant associations with sexual problems. Discussion HTN and its treatment are associated with sexual inactivity; diuretics more than other medication classes. In men but not women, treatment is also associated with sexual problems but medication class has no effect. More research investigating gender-specific mechanisms linking HTN and its treatment with sexual health is needed.

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Medication class enrichment analysis: a novel algorithm to analyze multiple pharmacologic exposures simultaneously using electronic health record data

Journal of the American Medical Informatics Association ◽

10.1093/jamia/ocx162 ◽

2018 ◽

Vol 25 (7) ◽

pp. 780-789 ◽

Cited By ~ 1

Author(s):

Ravy K Vajravelu ◽

Frank I Scott ◽

Ronac Mamtani ◽

Hongzhe Li ◽

Jason H Moore ◽

...

Keyword(s):

Logistic Regression ◽

Sensitivity And Specificity ◽

Enrichment Analysis ◽

Effect Sizes ◽

Health Improvement ◽

Simulation Studies ◽

Signal To Noise ◽

Electronic Health Record Data ◽

Medication Class ◽

The Health Improvement Network

Abstract Objective Observational studies analyzing multiple exposures simultaneously have been limited by difficulty distinguishing relevant results from chance associations due to poor specificity. Set-based methods have been successfully used in genomics to improve signal-to-noise ratio. We present and demonstrate medication class enrichment analysis (MCEA), a signal-to-noise enhancement algorithm for observational data inspired by set-based methods. Materials and Methods We used The Health Improvement Network database to study medications associated with Clostridium difficile infection (CDI). We performed case-control studies for each medication in The Health Improvement Network to obtain odds ratios (ORs) for association with CDI. We then calculated the association of each pharmacologic class with CDI using logistic regression and MCEA. We also performed simulation studies in which we assessed the sensitivity and specificity of logistic regression compared to MCEA for ORs 0.1–2.0. Results When analyzing pharmacologic classes using logistic regression, 47 of 110 pharmacologic classes were identified as associated with CDI. When analyzing pharmacologic classes using MCEA, only fluoroquinolones, a class of antibiotics with biologically confirmed causation, and heparin products were associated with CDI. In simulation, MCEA had superior specificity compared to logistic regression across all tested effect sizes and equal or better sensitivity for all effect sizes besides those close to null. Discussion Although these results demonstrate the promise of MCEA, additional studies that include inpatient administered medications are necessary for validation of the algorithm. Conclusions In clinical and simulation studies, MCEA demonstrated superior sensitivity and specificity for identifying pharmacologic classes associated with CDI compared to logistic regression.

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