TY - JOUR
T1 - Treatment with rivastigmine or galantamine and risk of urinary incontinence
T2 - Results from a Dutch database study
AU - Kroger, Edeltraut
AU - Van Marum, Rob
AU - Souverein, Patrick
AU - Carmichael, Pierre Hugues
AU - Egberts, Toine
PY - 2015/3/1
Y1 - 2015/3/1
N2 - Treatment of Alzheimer disease (AD) with cholinesterase inhibitors (ChEIs) may increase the risk of urinary incontinence (UI). Objective: To assess whether ChEI use was associated with the risk of UI among older patients with AD. Methods: A crossover cohort study using the PHARMO Record Linkage System included 10years of data on drug dispensing histories for over two million Dutch residents. Included patients were aged 50 +, free of UI for the last 6months, received a first ChEI prescription during the study period, had at least 12months prior drug exposure history and one subsequent prescription of any drug. UI was defined as a first dispensing of a urinary spasmolytic or of incontinence products for at least 30days. Cox regression with time-varying covariates and multivariate adjustment allowed assessing whether UI incidence was associated with ChEI exposure. Results: Among 3154 patients there were 657 UI cases during a mean follow-up of 5.1years before a first ChEI dispensing, and 499 cases after ChEI initiation, during a mean follow-up of 2.0years. Among the 2700 participants free of UI one year before ChEI initiation, the adjusted hazard ratio (HR) for UI was 1.13 (95% CI: 0.97-1.32) when periods with ChEI use were compared to periods without ChEI use. Sensitivity analyses may suggest an increased risk in the 1st month after ChEI initiation (HR: 1.72, p=0.09) Conclusion: Worsening AD may increase incidence of UI, but no firm association between ChEI treatment and risk of UI could be shown from these data.
AB - Treatment of Alzheimer disease (AD) with cholinesterase inhibitors (ChEIs) may increase the risk of urinary incontinence (UI). Objective: To assess whether ChEI use was associated with the risk of UI among older patients with AD. Methods: A crossover cohort study using the PHARMO Record Linkage System included 10years of data on drug dispensing histories for over two million Dutch residents. Included patients were aged 50 +, free of UI for the last 6months, received a first ChEI prescription during the study period, had at least 12months prior drug exposure history and one subsequent prescription of any drug. UI was defined as a first dispensing of a urinary spasmolytic or of incontinence products for at least 30days. Cox regression with time-varying covariates and multivariate adjustment allowed assessing whether UI incidence was associated with ChEI exposure. Results: Among 3154 patients there were 657 UI cases during a mean follow-up of 5.1years before a first ChEI dispensing, and 499 cases after ChEI initiation, during a mean follow-up of 2.0years. Among the 2700 participants free of UI one year before ChEI initiation, the adjusted hazard ratio (HR) for UI was 1.13 (95% CI: 0.97-1.32) when periods with ChEI use were compared to periods without ChEI use. Sensitivity analyses may suggest an increased risk in the 1st month after ChEI initiation (HR: 1.72, p=0.09) Conclusion: Worsening AD may increase incidence of UI, but no firm association between ChEI treatment and risk of UI could be shown from these data.
KW - Alzheimer disease
KW - Cholinesterase inhibitors
KW - Database cohort study
KW - Pharmacoepidemiology
KW - Urinary incontinence
UR - http://www.scopus.com/inward/record.url?scp=84925332336&partnerID=8YFLogxK
U2 - https://doi.org/10.1002/pds.3741
DO - https://doi.org/10.1002/pds.3741
M3 - Article
C2 - 25652526
SN - 1053-8569
VL - 24
SP - 276
EP - 285
JO - Pharmacoepidemiology and Drug Safety
JF - Pharmacoepidemiology and Drug Safety
IS - 3
ER -