Comparative Risk of Neuropsychiatric Adverse Events Associated With Leukotriene-Receptor Antagonists Versus Inhaled Corticosteroids.

asthma inhaled corticosteroids leukotriene-receptor antagonists neuropsychiatric adverse events

Journal

The journal of allergy and clinical immunology. In practice
ISSN: 2213-2201
Titre abrégé: J Allergy Clin Immunol Pract
Pays: United States
ID NLM: 101597220

Informations de publication

Date de publication:
04 Oct 2024
Historique:
received: 01 04 2024
revised: 23 09 2024
accepted: 24 09 2024
medline: 7 10 2024
pubmed: 7 10 2024
entrez: 6 10 2024
Statut: aheadofprint

Résumé

Leukotriene-receptor antagonists (LTRA) and inhaled corticosteroids (ICS) are common controller medications for asthma, but limited studies examine their comparative risks on neuropsychiatric adverse events (NAEs) in asthma patients. To investigate the comparative risks of LTRA versus ICS on seven distinct categories of NAEs in asthma patients at a nationwide level. We conducted a nationwide cohort study during 2010-2021. Incident NAEs and its clinical subgroups (e.g., psychotic disorders, anxiety disorders, movement disorders, behavioral and emotional disorders, mood disorders, sleep-related disorders, and personality disorders) were assessed. Cox proportional hazards regressions were employed to quantify the comparative risks. There were 1,249,897 asthma patients aged 6-64 years. Incidence rates for NAEs were 25.10 per 1000 person-years among patients treated with LTRA, and 23.46 per 1000 person-years among those treated with ICS. The incidence rate difference was 1.64 [95%CI: 0.30-2.98] per 1000 person-years. Positive associations of NAEs and three clinical subgroups were found in patients treated with LTRA compared to ICS (hazard ratios (HR): 1.06 [95%CI: 1.00-1.12] for NAEs; HR: 1.88 [95%CI: 1.24-2.84] for psychotic disorders; HR: 1.10 [95%CI: 1.01-1.20] for anxiety disorders; and HR: 1.27 [95%CI: 1.02-1.58] for behavioral and emotional disorders), but not for movement disorders, mood disorders, sleep-related disorders, and personality disorders. This nationwide cohort study identified heightened risks, ranging from 6% to 88%, of NAEs and three clinical subgroups in asthma patients treated with LTRA compared to ICS. These findings underscore the necessity for clinicians to communicate with patients regarding potential neuropsychiatric harms when prescribing LTRA.

Sections du résumé

BACKGROUND BACKGROUND
Leukotriene-receptor antagonists (LTRA) and inhaled corticosteroids (ICS) are common controller medications for asthma, but limited studies examine their comparative risks on neuropsychiatric adverse events (NAEs) in asthma patients.
OBJECTIVE OBJECTIVE
To investigate the comparative risks of LTRA versus ICS on seven distinct categories of NAEs in asthma patients at a nationwide level.
METHODS METHODS
We conducted a nationwide cohort study during 2010-2021. Incident NAEs and its clinical subgroups (e.g., psychotic disorders, anxiety disorders, movement disorders, behavioral and emotional disorders, mood disorders, sleep-related disorders, and personality disorders) were assessed. Cox proportional hazards regressions were employed to quantify the comparative risks.
RESULTS RESULTS
There were 1,249,897 asthma patients aged 6-64 years. Incidence rates for NAEs were 25.10 per 1000 person-years among patients treated with LTRA, and 23.46 per 1000 person-years among those treated with ICS. The incidence rate difference was 1.64 [95%CI: 0.30-2.98] per 1000 person-years. Positive associations of NAEs and three clinical subgroups were found in patients treated with LTRA compared to ICS (hazard ratios (HR): 1.06 [95%CI: 1.00-1.12] for NAEs; HR: 1.88 [95%CI: 1.24-2.84] for psychotic disorders; HR: 1.10 [95%CI: 1.01-1.20] for anxiety disorders; and HR: 1.27 [95%CI: 1.02-1.58] for behavioral and emotional disorders), but not for movement disorders, mood disorders, sleep-related disorders, and personality disorders.
CONCLUSIONS CONCLUSIONS
This nationwide cohort study identified heightened risks, ranging from 6% to 88%, of NAEs and three clinical subgroups in asthma patients treated with LTRA compared to ICS. These findings underscore the necessity for clinicians to communicate with patients regarding potential neuropsychiatric harms when prescribing LTRA.

Identifiants

DOI: 10.1016/j.jaip.2024.09.028 PMID: 39369853
pubmed: 39369853
pii: S2213-2198(24)00955-3
doi: 10.1016/j.jaip.2024.09.028
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

Copyright © 2024. Published by Elsevier Inc.

Auteurs

Tsung-Chieh Yao (TC)

Division of Allergy, Asthma, and Rheumatology, Department of Pediatrics, Chang Gung Memorial Hospital, Taoyuan, Taiwan; School of Medicine, Chang Gung University College of Medicine, Taoyuan, Taiwan. Electronic address: yao@adm.cgmh.org.tw.

Jing-Long Huang (JL)

School of Medicine, Chang Gung University College of Medicine, Taoyuan, Taiwan; Department of Pediatrics, New Taipei Municipal TuCheng Hospital, New Taipei, Taiwan.

Chi-Shin Wu (CS)

National Center for Geriatrics and Welfare Research, National Health Research Institutes, Zhunan, Taiwan; Department of Psychiatry, National Taiwan University Hospital, Yunlin branch, Douliu, Taiwan.

Henry Horng-Shing Lu (H)

Institute of Statistics, National Yang Ming Chiao Tung University, Hsinchu, Taiwan.

Yen-Chen Chang (YC)

Institute of Population Health Sciences, National Health Research Institutes, Miaoli, Taiwan.

Wei-Yu Chen (WY)

Department of Pediatrics, Chi-Mei Medical Center, Tainan, Taiwan.

Hui-Fang Kao (HF)

Department of Nursing, National Tainan Junior College of Nursing, Tainan, Taiwan.

Ann Chen Wu (AC)

Harvard Medical School, Boston, MA, USA.

Hui-Ju Tsai (HJ)

Institute of Population Health Sciences, National Health Research Institutes, Miaoli, Taiwan; National Tsing Hua University, Hsinchu, Taiwan. Electronic address: tsaihj@nhri.edu.tw.

Classifications MeSH