Alzheimer's disease and related dementias risk: Comparing users of non‐selective and M3‐selective bladder antimuscarinic drugs. Issue 12 (27th August 2020)

• Record Type: Journal Article
• Authors: Barthold, Douglas; Marcum, Zachary A.; Gray, Shelly L.; Zissimopoulos, Julie
• Is Part Of: Pharmacoepidemiology and drug safety. Volume 29:Issue 12(2020)
• Page Start: 1650
• Page End: 1658
• Publication Date: 2020-08-27
• Subjects: Alzheimer's disease and related dementiasanticholinergics -- bladder -- antimuscarinics -- pharmaco epidemiology; Pharmacoepidemiology -- Periodicals; Chemotherapy -- Periodicals; Epidemiology -- Periodicals; 615.705
• DOI: 10.1002/pds.5098
• Languages: English
• ISSNs: 1053-8569

Abstract

Abstract: Purpose: Bladder antimuscarinic (BAM) drug use is associated with increased risk of Alzheimer's disease and related dementias (ADRD). It is hypothesized that BAMs with non‐selective receptor binding may increase ADRD risk more than M3‐selective BAMs. This study compared ADRD risk for users of non‐selective and M3‐selective BAMs and examines ADRD risk associated with overall BAM use. Methods: Retrospective cohort study of Medicare claims for 71 688 individuals who used BAM drugs during 2007‐2009 without an ADRD diagnosis. We compared ADRD incidence (2011‐2016) between non‐selective BAM users (fesoterodine, flavoxate, oxybutynin, tolterodine, trospium) and M3‐selective BAM users (darifenacin, solifenacin). Logistic regressions compared individuals using target drugs in the same category of total standardized daily doses (TSDD) as a standardized measure of drug exposure, and adjusted for age, sex, race/ethnicity, healthcare utilization, other medication use, socioeconomic status, and comorbidities. Secondary analyses compared ADRD risk associated with different doses of BAMs overall. Results: Non‐selective BAM use (compared to M3‐selective) was not significantly associated with ADRD incidence. Odds ratios for non‐selective use were 0.97 (CI: 0.89‐1.04) for 1‐364 TSDD, 0.94 (CI: 0.83‐1.06) for 365‐729, 1.00 (CI: 0.87‐1.16) for 730‐1094, and 1.03 (CI: 0.88‐1.20) for >1094. Higher TSDD of BAMs overall (combining both non‐selective and M3‐selective BAMs), when compared to 1‐364 TSDD, were associated with increased ADRD incidence (OR = 1.05 (CI: 0.99‐1.10) for 365‐729, OR = 1.11 (CI: 1.05‐1.17) for 730‐1094, and OR = 1.10 (CI: 1.04‐1.15) for >1094). Conclusions: Non‐selective and M3‐selective BAM users had similar odds of ADRD incidence, and BAM use overall was significantly associated with ADRD incidence.