Risk of pregnancy loss in patients exposed to mycophenolate compared to azathioprine: A retrospective cohort study.
Abortion, Spontaneous
/ chemically induced
Adolescent
Adult
Azathioprine
/ adverse effects
Child
Databases, Factual
Female
Humans
Immunosuppressive Agents
/ adverse effects
Middle Aged
Mycophenolic Acid
/ adverse effects
Pregnancy
Retrospective Studies
Risk Assessment
Risk Factors
Stillbirth
Young Adult
azathioprine
miscarriage
mycophenolate
pharmacoepidemiology
pregnancy loss
spontaneous abortion
stillbirth
Journal
Pharmacoepidemiology and drug safety
ISSN: 1099-1557
Titre abrégé: Pharmacoepidemiol Drug Saf
Pays: England
ID NLM: 9208369
Informations de publication
Date de publication:
06 2020
06 2020
Historique:
received:
03
12
2019
revised:
08
04
2020
accepted:
09
04
2020
pubmed:
30
4
2020
medline:
22
4
2021
entrez:
30
4
2020
Statut:
ppublish
Résumé
To evaluate the relative risk of pregnancy loss associated with mycophenolate (MPA) vs azathioprine (AZA) use. We conducted a retrospective cohort study using the IBM MarketScan Research Databases (2005-2015). Patients with ≥1 MPA or AZA prescription claim during the first trimester were included. The study outcome was pregnancy loss (spontaneous abortion or stillbirth). Potential confounders included age, drug indications, comorbidities, other teratogenic medication use, and gestational age at first MPA or AZA prescription fill. The risk for pregnancy loss was estimated using a generalized estimating equation model with stabilized inverse probability of treatment weighting. In sensitivity analyses, we varied the exposure definition, outcome definition, and the analytical method. Among 111 pregnancies exposed to MPA, 55 resulted in pregnancy loss (49.5%). Among 471 pregnancies exposed to AZA, 113 had pregnancy loss (24.0%). The unadjusted relative risk for pregnancy loss was 2.0 (95% CI 1.6, 2.6), and the adjusted relative risk was 1.9 (95% CI, 1.6, 2.3) compared to AZA. Relative risk estimates were stable in all sensitivity analyses. Exposure to MPA during early pregnancy was associated with a 2-fold increase in pregnancy loss risk.
Substances chimiques
Immunosuppressive Agents
0
Mycophenolic Acid
HU9DX48N0T
Azathioprine
MRK240IY2L
Types de publication
Comparative Study
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
716-724Informations de copyright
© 2020 John Wiley & Sons Ltd.
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