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Desideri G, Pegoraro V, Cipelli R, Ripellino C, Miroddi M, Meto S, Gori M, Fabrizzi P. Extemporaneous combination therapy with nebivolol/ramipril for the treatment of hypertension: a real-world evidence study in Europe. Curr Med Res Opin 2024; 40:1093-1102. [PMID: 38832726 DOI: 10.1080/03007995.2024.2362276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2024] [Accepted: 05/28/2024] [Indexed: 06/05/2024]
Abstract
OBJECTIVES To describe the clinical characteristics and treatment adherence in European adult hypertensive patients starting treatment with the extemporaneous combination of nebivolol and ramipril (NR-EXC). METHODS Retrospective database analysis of patients receiving NR-EXC treatment across five European countries (Italy, Germany, France, Poland, Hungary) over a period ranging from 3 to 9 years (until 30 June 2020) according to data availability for the different data sources. Patient demographics, comorbidities, and treatment adherence were evaluated. RESULTS We identified 592,472 patients starting NR-EXC. Most of them were over 60 years of age, with ramipril most commonly prescribed at 5 mg (from 30.0 to 57.2% of patients across the databases). Notable comorbidities included diabetes (19.2%) and dyslipidemia (18.2%). The study population was also highly subjected to polytherapy with antithrombotics, lipid-lowering agents, and other lowering blood pressure agents as the most co-prescribed medications, as resulted from Italian database. Up to 59% of the patients did not request a cardiologic visit during the study period. Adherence to therapy was low in 56.3% of the patients, and it was high only in 11.1% of them. CONCLUSIONS The combination of nebivolol and ramipril is frequently prescribed in Europe, but adherence to treatment is suboptimal. The transition to a single pill combination could enhance treatment adherence and streamline regimens, potentially leading to significant benefits. Improved adherence not only correlates with better blood pressure control but also reduces the risk of cardiovascular events, underscoring the importance of this development.
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Affiliation(s)
- Giovambattista Desideri
- Department of Clinical, Internal, Anesthesiologic and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy
| | | | | | | | - Marco Miroddi
- A. Menarini Farmaceutica Internazionale S.r.l., Florence, Italy
| | - Suada Meto
- A. Menarini Industrie Farmaceutiche Riunite S.r.l., Florence, Italy
| | | | - Paolo Fabrizzi
- A. Menarini Industrie Farmaceutiche Riunite S.r.l., Florence, Italy
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Jin R, Kruppert S, Scholz F, Bardoulat I, Karzazi K, Morand F, Kricorian G, Collier D, Kay J. Treatment Persistence and Switching Patterns of Adalimumab Biosimilar ABP 501 in European Patients with Rheumatologic Diseases. Rheumatol Ther 2024; 11:523-537. [PMID: 38436916 PMCID: PMC11111632 DOI: 10.1007/s40744-024-00647-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Accepted: 01/31/2024] [Indexed: 03/05/2024] Open
Abstract
INTRODUCTION ABP 501 was an adalimumab (ADA) biosimilar approved for treating immune-mediated inflammatory diseases (IMIDs) including rheumatoid arthritis (RA), psoriatic arthritis (PsA), and ankylosing spondylitis (AS). In this retrospective study, we aimed to examine the treatment patterns of ABP 501 among patients with these IMIDs using German and French pharmacy claims databases. METHODS Patients with RA, PsA, or AS who initiated ABP 501 between October 2018 and March 2020 and were observed continuously for ≥ 365 days both before and after ABP 501 initiation were included. Descriptive analyses of persistence and switch after ABP 501 discontinuation were conducted and reported for each disease cohort by prior use of ADA products (patients naïve to ADA or patients experienced with ADA). RESULTS Median (95% confidence interval) persistence on ABP 501 was 9.4 (8.6-10.3), 10.2 (9.0-11.7), and 12.1 (11.0-13.1) months in German patients, and 11.7 (9.9-13.3), 7.1 (5.8-8.4), and 10.8 (9.6-11.9) months in French patients for RA, PsA, and AS, respectively. For patients who switched from ABP 501 to another targeted therapy during the first 12 months of follow-up, switching patterns varied between patients naïve to ADA and patients experienced with ADA in both Germany and France, with patients naïve to ADA switching most frequently to other targeted therapies including non-ADA tumor necrosis factor inhibitor (TNFi), non-TNFi biologic, or Janus Kinase inhibitor (JAKi) and patients experienced with ADA switching most frequently back to ADA reference product (RP). CONCLUSIONS Across three rheumatologic diseases, about half of patients persisted on ABP 501 at the end of 12 months after treatment initiation in both Germany and France. Patients experienced with ADA were more likely to switch back to ADA RP, regardless of indication and country, suggesting a possible nocebo effect. Future studies are warranted to understand reasons of discontinuation and switching.
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Affiliation(s)
- Ran Jin
- Amgen Inc., Thousand Oaks, CA, USA.
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Jin R, Kruppert S, Scholz F, Bardoulat I, Karzazi K, Kricorian G, O’Kelly JL, Reinisch W. Treatment persistence and switching patterns of ABP 501 in European patients with inflammatory bowel disease. Therap Adv Gastroenterol 2024; 17:17562848231222332. [PMID: 38221908 PMCID: PMC10787526 DOI: 10.1177/17562848231222332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Accepted: 12/06/2023] [Indexed: 01/16/2024] Open
Abstract
Background Approval of the adalimumab (ADA) biosimilar ABP 501 for inflammatory bowel disease (IBD) indications was based on the principle of extrapolation, without indication-specific clinical trial data. Objectives To evaluate the real-world treatment patterns of ABP 501 in patients with IBD. Design Retrospective analysis of pharmacy claims data from Germany and France. Methods Continuously insured adult IBD patients who initiated ABP 501 between October 2018 and March 2020 were included. Treatment persistence, adherence, and post-ABP 501 switching patterns were evaluated for two mutually exclusive groups: ADA-naïve patients (i.e. no baseline use of ADA products) and ADA-experienced patients (i.e. previously treated with ADA products). Results A total of 3362 German patients and 733 French patients were included, with 54.4% and 65.3% being ADA-naïve patients, respectively. Median persistence (95% CI) on ABP 501 was 10.9 months (9.8-11.6) in ADA-naïve patients and 14.2 months (12.7-15.2) in ADA-experienced patients in Germany; for the French cohort, ADA-naïve and -experienced patients had median persistence of 12.8 months (10.2-14.7) and 11.5 months (8.8-14.4), respectively. During the first 12 months of ABP 501 initiation, 53.7% of German patients and 51.0% of French patients were adherent to the therapy. About 20% of patients in both countries switched from ABP 501 to another targeted therapy. In the German cohort, ADA-naïve patients most frequently switched to non-tumor necrosis factor inhibitor biologics, but ADA-experienced patients most commonly switched to reference product (RP); in the French cohort, patients most often switched to RP regardless of prior exposure to ADA products. Conclusion About 50% of patients persisted on and were adherent to ABP 501 therapy during the first 12 months after treatment initiation in two large European countries. Post-ABP 501, switching patterns varied between countries, indicating diversified treatment practices warranting further research on reason(s) for switching and potential overall treatment outcomes.
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Affiliation(s)
- Ran Jin
- Amgen Inc., 1 Amgen Center Dr, Thousand Oaks, CA 91320, USA
| | | | | | | | | | | | | | - Walter Reinisch
- Division of Gastroenterology and Hepatology, Medical University of Vienna, Vienna, Austria
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Charriot J, Descamps V, Jankowski R, Maravic M, Bourdin A. Multiple Biologics for Multiple T2 Diseases: A Pharmacoepidemiological Algorithm for Sorting Out Patients by Indication. J Asthma Allergy 2023; 16:1287-1295. [PMID: 38050615 PMCID: PMC10693777 DOI: 10.2147/jaa.s424152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2023] [Accepted: 11/07/2023] [Indexed: 12/06/2023] Open
Abstract
Background Several biologics (Bx) and targeted synthetic drugs (TSD) exist to treat T2 diseases, including chronic spontaneous urticaria (CSU), severe asthma (SA), chronic rhinosinusitis with nasal polyposis (CRSwNP) or atopic dermatitis (AD). Objective To identify patients treated with Bx/TSD from a dynamic dispensing database using an algorithm-based methodology. Methods We used the LRx database (Lifelink Treatment dynamics, IQVIA) which covers nearly 45% of the French retail pharmacies. Patients who had at least one Bx/TSD dispensing from April 2021 to March 2022 were included. An algorithm was designed to determine the indication of the Bx/TSD prescription analyzing all previous drug dispensation since March 2012 following a 3-steps procedure. Results A total of 21,677 patients received at least one Bx/TSD between March 2021 and April 2022. The algorithm identified 91.7% (n = 19,884) patients with a T2 disease (AD = 18.4%, CRSwNP = 1.5%, SA = 59.5%, and CSU = 12.4%), the rest having either an association of diseases (1%) or an undetermined one (7.3%). SA was the main reason for Bx/TSD initiation (52%), followed by AD (29%), CSU (14%) and CRSwNP (5%). For SA patients already under biologic at entry, omalizumab was the most frequently prescribed (48%) followed by benralizumab, mepolizumab (22% each) and dupilumab (8%). Dupilumab was mostly prescribed for AD patients (89% for patient-initiated vs 96% for patient-renewed) followed by baricitinib. Conclusion The algorithm was able to identify patients with T2 diseases under Bx/TSD treatments. This tool may help to follow the evolution of prescription patterns in the future.
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Affiliation(s)
- Jeremy Charriot
- Department of Respiratory Diseases, University of Montpellier, PhyMedExp, INSERM, CNRS UMR, CHU Montpellier, Montpellier, France
| | - Vincent Descamps
- Department of Dermatology, Hôpital Bichat AP-HP Nord - University of Paris Cité, Paris, France
| | - Roger Jankowski
- Service d’ORL et de Chirurgie Cervico-Faciale, CHRU – Institut Louis Mathieu, Vandoeuvre, France
| | - Milka Maravic
- Department of Rheumatology, Lariboisière Hospital Lariboisière, APHP Nord, Paris, France
- General Management, IQVIA, Paris, France
| | - Arnaud Bourdin
- Department of Respiratory Diseases, University of Montpellier, PhyMedExp, INSERM, CNRS UMR, CHU Montpellier, Montpellier, France
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Padovani A, Falato S, Pegoraro V. Extemporaneous combination of donepezil and memantine to treat dementia in Alzheimer disease: evidence from Italian real-world data. Curr Med Res Opin 2023; 39:567-577. [PMID: 36803101 DOI: 10.1080/03007995.2023.2182530] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/23/2023]
Abstract
OBJECTIVE Providing evidence on donepezil and memantine administration as extemporaneous combination (DM-EXT) to treat Alzheimer Disease (AD) in Italy, and describing demographic and clinical features of AD patients prescribed DM-EXT. METHODS Retrospective observational study using IQVIA Italian LifeLink Treatment Dynamics (LRx) and Longitudinal Patient Database (LPD). Prevalent users of DM-EXT were identified on the databases (cohorts DMpLRx and DMpLPD) including patients with donepezil and memantine overlapping prescriptions during the selection period (DMpLRx: "July 2018-June 2021"; DMpLPD: "July 2012-June 2021"). Demographic and clinical profiles of patients were provided. Starting from cohort DMpLPD, new users of DM-EXT were selected to calculate treatment adherence. Three additional cohorts of prevalent users of DM-EXT were identified on IQVIA LRx over subsequent 12-month periods, from July 2018 to June 2021, to get national-level yearly estimates accounting for database representativeness. RESULTS Cohorts DMpLRx and DMpLPD included 9862 and 708 patients, respectively. For both cohorts, two-third of patients were female, and more than half were aged 80+. Concomitant conditions and co-treatments prevalence was very high; most frequent comorbidities included psychiatric and cardiovascular diseases. An intermediate-to-high adherence was observed in 57% of DM-EXT new users. National-level yearly estimates showed an increasing trend (+4%) in DM-EXT prescription, which led to estimate about 10,000 patients being treated during the period "July 2020-June 2021". CONCLUSIONS Prescription of DM-EXT is a common practice in Italy. Because the administration of fixed-dose (FDCs) instead of extemporaneous combinations improves treatment adherence, the introduction of an FDC containing donepezil and memantine might enhance AD patients' management and reduce caregiver burden.
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Affiliation(s)
- Alessandro Padovani
- Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Serena Falato
- RWS Department, IQVIA Solutions Italy S.r.l, Milan, Italy
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Joumaa H, Sigogne R, Maravic M, Perray L, Bourdin A, Roche N. Artificial intelligence to differentiate asthma from COPD in medico-administrative databases. BMC Pulm Med 2022; 22:357. [PMID: 36127649 PMCID: PMC9487098 DOI: 10.1186/s12890-022-02144-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Accepted: 08/26/2022] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION Discriminating asthma from chronic obstructive pulmonary disease (COPD) using medico-administrative databases is challenging but necessary for medico-economic analyses focusing on respiratory diseases. Artificial intelligence (AI) may improve dedicated algorithms. OBJECTIVES To assess performance of different AI-based approaches to distinguish asthmatics from COPD patients in medico-administrative databases where the clinical diagnosis is absent. An "Asthma COPD Overlap" category was defined to further test whether AI can detect complexity. METHODS This study included 178,962 patients treated by two "R03" treatment prescriptions at least from January 2016 to December 2018 and managed by either a general practitioner and/or a pulmonologist participating in a permanent longitudinal observatory of prescription in ambulatory medicine (LPD). Clinical diagnoses are available in this database and were used as gold standards to develop diagnostic rules. Three types of AI approaches were explored using data restricted to demographics and treatment dispensations: multinomial regression, gradient boosting and recurrent neural networks (RNN). The best performing model (based on metric properties) was then applied to estimate the size of asthma and COPD populations based on a database (LRx) of treatment dispensations between July, 2018 and June, 2019. RESULTS The best models were obtained with the boosting approach and RNN, with an overall accuracy of 68%. Performance metrics were better for asthma than COPD. Based on LRx data, the extrapolated numbers of patients treated for asthma and COPD in France were 3.7 and 1.2 million, respectively. Asthma patients were younger than COPD patients (mean, 49.9 vs. 72.1 years); COPD occurred mostly in men (68%) compared to asthma (33%). CONCLUSION AI can provide models with acceptable accuracy to distinguish between asthma, ACO and COPD in medico-administrative databases where the clinical diagnosis is absent. Deep learning and machine learning (RNN) had similar performances in this regard.
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Affiliation(s)
- Hassan Joumaa
- Department of Respiratory Medicine, Cochin Hospital, Assistance Publique - Hôpitaux de Paris (APHP), Paris, France.
| | | | - Milka Maravic
- IQVIA, La Défense, France.,Hôpital Lariboisière, Rhumatologie, Paris, France
| | | | - Arnaud Bourdin
- PhyMedExp, INSERM U1046, CNRS UMR 9214, University of Montpellier, Montpellier, France.,Department of Respiratory Medicine, Arnaud de Villeneuve Hospital, CHU Montpellier, Montpellier, France
| | - Nicolas Roche
- Department of Respiratory Medicine, Cochin Hospital, Assistance Publique - Hôpitaux de Paris (APHP), Paris, France.,University Paris Descartes (EA2511), Paris, France
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Richette P, Allez M, Descamps V, Perray L, Pilet S, Latourte A, Maravic M. Impact de la COVID-19 sur l’initiation des prescriptions des biothérapies dans les maladies inflammatoires chroniques. REVUE DU RHUMATISME 2022; 89:313-314. [PMID: 34697532 PMCID: PMC8529531 DOI: 10.1016/j.rhum.2021.10.560] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 07/13/2021] [Indexed: 12/01/2022]
Affiliation(s)
- Pascal Richette
- Rheumatology department, Lariboisière Hospital, AP-HP, Paris, France
- Inserm U1132, Paris University, Paris, France
| | - Matthieu Allez
- Gastro Enterology department, St-Louis Hospital, AP-HP, Paris, France
| | | | | | | | - Augustin Latourte
- Rheumatology department, Lariboisière Hospital, AP-HP, Paris, France
- Inserm U1132, Paris University, Paris, France
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Richette P, Allez M, Descamps V, Perray L, Pilet S, Latourte A, Maravic M. Impact of COVID-19 on initiation of biologic therapy prescriptions for chronic inflammatory diseases. Joint Bone Spine 2021; 89:105253. [PMID: 34314887 PMCID: PMC8305295 DOI: 10.1016/j.jbspin.2021.105253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Accepted: 07/13/2021] [Indexed: 12/03/2022]
Affiliation(s)
- Pascal Richette
- Rheumatology department, Lariboisière Hospital, AP-HP, 2, rue Ambroise Paré, 75010 Paris, France; Inserm U1132, Paris University, Paris, France.
| | - Matthieu Allez
- Gastro Enterology department, St-Louis Hospital, AP-HP, Paris, France
| | | | | | | | - Augustin Latourte
- Rheumatology department, Lariboisière Hospital, AP-HP, 2, rue Ambroise Paré, 75010 Paris, France; Inserm U1132, Paris University, Paris, France
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Bounoure F, Mouly D, Beaudeau P, Bentayeb M, Chesneau J, Jones G, Skiba M, Lahiani-Skiba M, Galey C. Syndromic Surveillance of Acute Gastroenteritis Using the French Health Insurance Database: Discriminatory Algorithm and Drug Prescription Practices Evaluations. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17124301. [PMID: 32560168 PMCID: PMC7345322 DOI: 10.3390/ijerph17124301] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/24/2020] [Revised: 06/12/2020] [Accepted: 06/14/2020] [Indexed: 01/26/2023]
Abstract
The French national public health agency (Santé publique France) has used data from the national health insurance reimbursement system (SNDS) to identify medicalised acute gastroenteritis (mAGE) for more than 10 years. This paper presents the method developed to evaluate this system: performance and characteristics of the discriminatory algorithm, portability in mainland and overseas French departments, and verification of the mAGE database updating process. Pharmacy surveys with certified mAGE from 2012 to 2015 were used to characterise mAGE and to estimate the sensitivity and predictive positive value (PPV) of the algorithm. Prescription characteristics from these pharmacy surveys and from 2014 SNDS prescriptions in six mainland and overseas departments were compared. The sensitivity (0.90) and PPV (0.82) did not vary according to the age of the population or year. Prescription characteristics were similar within all studied departments. This confirms that the algorithm can be used in all French departments, for both paediatric and adult populations, with stability and durability over time. The algorithm can identify mAGE cases at a municipal level. The validated system has been implemented in a national waterborne disease outbreaks surveillance system since 2019 with the aim of improving the prevention of infectious disease risk attributable to localised tap water systems.
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Affiliation(s)
- Frederic Bounoure
- Laboratory of Pharmaceutical & Biopharmaceutical Technology, UFR of Health, Normandy University, Unirouen, 22 Bd Gambetta, 76183 Rouen Cedex, France; (M.S.); (M.L.-S.)
- DC2N, INSERM U1239, Unirouen, Normandy University, 76128 Mont Saint Aignan, France
- Correspondence:
| | - Damien Mouly
- Santé Publique France, French National Public Health Agency, F-94415 Saint-Maurice, France; (D.M.); (P.B.); (M.B.); (J.C.); (G.J.); (C.G.)
| | - Pascal Beaudeau
- Santé Publique France, French National Public Health Agency, F-94415 Saint-Maurice, France; (D.M.); (P.B.); (M.B.); (J.C.); (G.J.); (C.G.)
| | - Malek Bentayeb
- Santé Publique France, French National Public Health Agency, F-94415 Saint-Maurice, France; (D.M.); (P.B.); (M.B.); (J.C.); (G.J.); (C.G.)
| | - Julie Chesneau
- Santé Publique France, French National Public Health Agency, F-94415 Saint-Maurice, France; (D.M.); (P.B.); (M.B.); (J.C.); (G.J.); (C.G.)
| | - Gabrielle Jones
- Santé Publique France, French National Public Health Agency, F-94415 Saint-Maurice, France; (D.M.); (P.B.); (M.B.); (J.C.); (G.J.); (C.G.)
| | - Mohamed Skiba
- Laboratory of Pharmaceutical & Biopharmaceutical Technology, UFR of Health, Normandy University, Unirouen, 22 Bd Gambetta, 76183 Rouen Cedex, France; (M.S.); (M.L.-S.)
- DC2N, INSERM U1239, Unirouen, Normandy University, 76128 Mont Saint Aignan, France
| | - Malika Lahiani-Skiba
- Laboratory of Pharmaceutical & Biopharmaceutical Technology, UFR of Health, Normandy University, Unirouen, 22 Bd Gambetta, 76183 Rouen Cedex, France; (M.S.); (M.L.-S.)
- DC2N, INSERM U1239, Unirouen, Normandy University, 76128 Mont Saint Aignan, France
| | - Catherine Galey
- Santé Publique France, French National Public Health Agency, F-94415 Saint-Maurice, France; (D.M.); (P.B.); (M.B.); (J.C.); (G.J.); (C.G.)
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Vilcu AM, Sabatte L, Blanchon T, Souty C, Maravic M, Lemaitre M, Steichen O, Hanslik T. Association Between Acute Gastroenteritis and Continuous Use of Proton Pump Inhibitors During Winter Periods of Highest Circulation of Enteric Viruses. JAMA Netw Open 2019; 2:e1916205. [PMID: 31774521 PMCID: PMC6902831 DOI: 10.1001/jamanetworkopen.2019.16205] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
IMPORTANCE An increased risk of acute bacterial enteric infections has been reported among patients receiving proton pump inhibitor (PPI) therapy. The risk of acute gastroenteritis (AGE) of viral origin associated with continuous PPI exposure has been less studied. OBJECTIVE To investigate the association between continuous PPI therapy and AGE occurrence during winter epidemic periods when the circulation of enteric viruses is the highest. DESIGN, SETTING, AND PARTICIPANTS A matched cohort study was performed using a prospectively collected drug dispensing database from a large panel of community pharmacies in continental France. All patients recorded in the database during the 2015 to 2016 winter season, with documented age, sex, and use of an identifiable regular panel pharmacy, were eligible for the study. Each patient exposed to continuous PPI therapy was matched to 3 unexposed patients, according to year of birth, sex, and identifiable regular panel pharmacy. Analyses were performed between January 2017 and December 2018. EXPOSURE Continuous PPI use during the 2015 to 2016 AGE winter epidemic. MAIN OUTCOMES AND MEASURES The occurrence of at least 1 AGE episode during the 2015 to 2016 AGE winter epidemic was the main outcome. Episodes of AGE were identified using a previously validated algorithm based on drug dispensing data. Relative risks of AGE were estimated using a multivariable log-binomial model adjusted for age, sex, and treatments for chronic conditions. RESULTS There were 233 596 patients receiving PPI therapy (median [interquartile range] age, 71 [62-81] years; 55.8% female) and 626 887 matched patients not receiving PPI therapy (median [interquartile range] age, 70 [61-80] years; 56.3% female) included in the analyses. At least 1 AGE epidemic episode was identified in 3131 patients (1.3%) receiving PPI therapy and in 4327 patients (0.7%) not receiving PPI therapy. The adjusted relative risk of AGE for those receiving PPI therapy was 1.81 (95% CI, 1.72-1.90) for all ages considered, 1.66 (95% CI, 1.54-1.80) among those aged 45 to 64 years, 2.19 (95% CI, 1.98-2.42) among those aged 65 to 74 years, and 1.98 (95% CI, 1.82-2.15) among those aged 75 years and older. CONCLUSIONS AND RELEVANCE Continuous PPI therapy was associated with an increased risk of developing AGE during periods of highest circulation of enteric viruses. These findings support the hypothesis that PPI use is associated with an increased risk of enteric viral infections.
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Affiliation(s)
- Ana-Maria Vilcu
- Sorbonne Université, INSERM, Institut Pierre Louis d’épidémiologie et de Santé Publique (IPLESP UMRS 1136), Paris, France
| | - Laure Sabatte
- Sorbonne Université, INSERM, Institut Pierre Louis d’épidémiologie et de Santé Publique (IPLESP UMRS 1136), Paris, France
| | - Thierry Blanchon
- Sorbonne Université, INSERM, Institut Pierre Louis d’épidémiologie et de Santé Publique (IPLESP UMRS 1136), Paris, France
| | - Cécile Souty
- Sorbonne Université, INSERM, Institut Pierre Louis d’épidémiologie et de Santé Publique (IPLESP UMRS 1136), Paris, France
| | - Milka Maravic
- Real World Insight, IQVIA, La Défense Cedex, France
- Service de Rhumatologie, Hôpital Lariboisière, Assistance Publique–Hôpitaux de Paris (APHP), Paris, France
| | | | - Olivier Steichen
- Sorbonne Université, INSERM, Université Paris 13, Laboratoire d’informatique Médicale et d’Ingénierie des Connaissances en e-santé, LIMICS, Paris, France
- Service de Médecine Interne, Hôpital Tenon, Assistance Publique–Hôpitaux de Paris (APHP), Paris, France
| | - Thomas Hanslik
- Sorbonne Université, INSERM, Institut Pierre Louis d’épidémiologie et de Santé Publique (IPLESP UMRS 1136), Paris, France
- UVSQ, UFR de Médecine, Université de Versailles Saint-Quentin-en-Yvelines, Versailles, France
- Service de Médecine Interne, Hôpital Ambroise Paré, Assistance Publique–Hôpitaux de Paris (APHP), Boulogne Billancourt, France
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Affiliation(s)
- Kaleen N Hayes
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Nardine R Nakhla
- School of Pharmacy, University of Waterloo, Kitchener, Ontario, Canada
| | - Mina Tadrous
- Women's College Hospital, Toronto, Ontario, Canada
- Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario, Canada
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