Risk of Acute Asthma Attacks Associated With Nonsteroidal Anti-inflammatory Drugs: A Self-Controlled Case Series

Takeuchi, Yoshinori; Ando, Takashi; Ishiguro, Chieko; Uyama, Yoshiaki

doi:10.1177/2168479016679865

Cited by 8 publications

(5 citation statements)

References 30 publications

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“…The summary statistics for the variables included in the model are shown in S4 Table . The seasons were defined as spring (March to May), summer (June to August), autumn (September to November), and winter (December to February) based on a previous study of SCCS in Japanese patients with asthma [ 24 ]. For SABA, with or without prescription was included in each period, and for exacerbation history, the number of days since the last exacerbation was included in each period.…”

Section: Methodsmentioning

confidence: 99%

Optimal follow-up period after switching to another inhaled corticosteroid/long-acting β2 agonist in patients with asthma: A retrospective study using Japanese administrative claims data

Kondo¹,

Maeda

Kikuchi

et al. 2022

PLoS ONE

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Switching inhalation devices is a reasonable option if problems with control, adherence, or inhalation technique occur in patients with asthma treated with inhaled corticosteroid (ICS)/long-acting β2 agonist (LABA). However, evidence to determine the extent to which the carefully monitored period persists after switching is insufficient. In this study, we aimed to investigate the duration of the carefully monitored period after switching to another ICS/LABA. This retrospective study used claims data from Japanese health insurance associations from May 2014 to April 2019. A total of 1,951 patients who switched to another ICS/LABA during the study period were selected for analysis. The relative risk of the first exacerbation after switching was calculated for each four-week interval after the switch compared with that before the switch in a self-controlled case series design. We further assessed patient background associated with exacerbations during the follow-up period. In the primary analysis, the risk of asthma exacerbation compared to the control period was derived from a conditional logistic regression model, which showed a significant decrease immediately after the switch (1 to 4 weeks, Odds ratio [OR] 0.37, 95% confidence interval [CI] 0.26–0.54). Subsequently, the risk increased again and was not significantly different from the control period until week 32 (OR 0.55, 95% CI 0.29–1.04). In a sensitivity analysis among patients with a history of exacerbations, up to week 20 was the period of no continuous risk reduction (OR 0.84, 95% CI 0.41–1.70). In the secondary analysis, chronic rhinosinusitis, sleep disorders, and a history of asthma exacerbation were significantly associated with asthma exacerbation. The incidence of exacerbation remained high for approximately 4 to 7 months after patients with asthma switched to another ICS/LABA. Therefore, these patients should be carefully monitored for at least 4 to 7 months and should be re-assessed at an earlier point in time, if necessary.

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Section: Methodsmentioning

confidence: 99%

Optimal follow-up period after switching to another inhaled corticosteroid/long-acting β2 agonist in patients with asthma: A retrospective study using Japanese administrative claims data

Kondo¹,

Maeda

Kikuchi

et al. 2022

PLoS ONE

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“…9,12 The advantage of this analysis is that the effects of time-invariant confounders can be removed by comparing the risk period with other periods for the same person. In this study, we defined the overall IRR for Achilles tendon rupture as the ratio of the incidence rate in the exposure period compared with that in the nonexposure period, 12,13 as described subsequently.…”

Section: Self-controlled Case Series Analysismentioning

confidence: 99%

Association Between Third-Generation Fluoroquinolones and Achilles Tendon Rupture: A Self-Controlled Case Series Analysis

et al. 2021

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PURPOSE We investigated whether use of third-generation fluoroquinolones is associated with occurrence of Achilles tendon rupture using a case series analysis in which patients served as their own control. METHODSWe used administrative claims data to identify residents in a single Japanese prefecture who were enrolled in National Health Insurance and Elderly Health Insurance from April 2012 to March 2017 and experienced Achilles tendon rupture after receiving an antibiotic prescription. Antibiotics were categorized into 3 groups: first-and second-generation fluoroquinolones, third-generation fluoroquinolones, and nonfluoroquinolones. We used a conditional Poisson regression model to estimate the incidence rate ratio (IRR) of Achilles tendon rupture during the antibiotic exposure period relative to the nonexposure period for each patient. An exposure period was defined as 30 days from start of the prescription. RESULTSAnalyses were based on 504 patients with Achilles tendon rupture who had received antibiotic prescriptions. Risk of rupture was not significantly elevated during exposure to third-generation fluoroquinolones (IRR = 1.05; 95% CI, 0.33-3.37) and nonfluoroquinolones (IRR = 1.08; 95% CI, 0.80-1.47). In contrast, risk was significantly elevated during exposure to first-and second-generation fluoroquinolones (IRR = 2.94; 95% CI, 1.90-4.54). Findings were similar across subgroups stratified by sex and by recent corticosteroid use.CONCLUSIONS Our analysis showed that third-generation fluoroquinolone use was not associated with an increased risk of Achilles tendon rupture. These antibiotics may be a safer option for patients in whom this risk is elevated, such as athletes.

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“…Another pilot study involved the use of an SSA in a healthcare insurance claims database to comparatively evaluate the risk of hyperlipidemia associated with AAPs. 11 Because of difficulties in ascertaining the accuracy of the recorded diagnoses, we identified hyperlipidemia through prescriptions of antihyperlipidemic drugs. We analyzed 756 exposed cases who had been prescribed any AAP and had also experienced hyperlipidemia.…”

Section: Mihari Project: the First 5 Yearsmentioning

confidence: 99%

“…More than 40 pilot studies have been conducted using a national-level insurance claims database, a healthcare insurance claims database that covers a substantial portion of Japan, [7][8][9][10][11][12] a database comprising electronic medical records (EMRs) from six hospitals, 5,6,13,14 and an inpatient care database comprising data in a format compliant with the Diagnosis Procedure Combination system (which is a comprehensive inpatient reimbursement system analogous to the US diagnosis-related group system). 15,16 The characteristics of these data sources are summarized in the Table 1.…”

Section: Mihari Project: the First 5 Yearsmentioning

confidence: 99%

“…A variety of pharmacoepidemiological methods were employed in the pilot studies, including cohort studies, 10 nested case-control studies, 17 sequence symmetry analyses (SSA), 12,17 and self-controlled case series studies. 11 In addition, propensity score (PS) matching was used in cohort studies to adjust possible confounders. 10 The effects of safety regulatory actions were also examined using interrupted time series analyses.…”

Section: Mihari Project: the First 5 Yearsmentioning

confidence: 99%

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The MIHARI project: establishing a new framework for pharmacoepidemiological drug safety assessments by the Pharmaceuticals and Medical Devices Agency of Japan

Ishiguro

Takeuchi

Uyama

et al. 2016

Pharmacoepidemiology and Drug

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Risk of Acute Asthma Attacks Associated With Nonsteroidal Anti-inflammatory Drugs: A Self-Controlled Case Series

Abstract: The use of NSAIDs in Japan was associated with an increased risk of acute asthma attacks. However, this risk was lower in COX-2 selective NSAIDs.

Cited by 8 publications

References 30 publications

Optimal follow-up period after switching to another inhaled corticosteroid/long-acting β2 agonist in patients with asthma: A retrospective study using Japanese administrative claims data

Optimal follow-up period after switching to another inhaled corticosteroid/long-acting β2 agonist in patients with asthma: A retrospective study using Japanese administrative claims data

Association Between Third-Generation Fluoroquinolones and Achilles Tendon Rupture: A Self-Controlled Case Series Analysis

The MIHARI project: establishing a new framework for pharmacoepidemiological drug safety assessments by the Pharmaceuticals and Medical Devices Agency of Japan

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