Non- vs M3-selective antimuscarinics: similar risk for Alzheimer's disease
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Non- vs M3-selective antimuscarinics: similar risk for Alzheimer’s disease Muscarinic-receptor antagonists used for the treatment of overactive bladder (OAB) are associated with increased risk of Alzheimer’s disease and related dementias (ADRD), but there is no significant difference in ADRD risk between non-selective and M3-selective bladder antimuscarinic drugs at similar doses. These are the main findings of a retrospective cohort study that identified users of non-selective antimuscarinics (fesoterodine, flavoxate, oxybutynin, tolterodine and trospium) and M3-selective antimuscarinics (darifenacin and solifenacin) for the period from 2007 to 2009 based on Medicare claims data from 71 668 individuals. Subsequently, ADRD incidence for the period from 2011 to 2016 was compared between users of non-selective antimuscarinics and those of M3-selective antimuscarinics. The unadjusted ADRD incidence during 2011–2016 was 3.97% per year for users of non-selective antimuscarinics and 4.04% for M3-selective antimuscarinics. Regression analysis showed that use of non-selective antimuscarinics, compared to M3-selective agents, was not significantly associated with ADRD incidence for four exposure levels. Adjusted odds ratios for exposure to non-selective antimuscarinics, as compared to M3-selective agents, were 0.97 (CI 0.89, 1.04) for low exposure and 1.03 (CI 0.88, 1.20) for high exposure. The results were consistent in analyses by gender and race/ethnicity. The study also showed that users with greater exposure to any antimuscarinic (> 2 years) had significantly higher ADRD incidence than users with < 1 year of total exposure. Barthold D, et al. Alzheimer’s disease and related dementias risk: Comparing users of non-selective and M3-selective bladder antimuscarinic drugs. Pharmacoepidemiology 803501012 and Drug Safety : 27 Aug 2020. Available from: URL: http://doi.org/10.1002/pds.5098
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Reactions 12 Sep 2020 No. 1821
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