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Comparative risk of oral ulcerations among antipsychotics users - population-based retrospective cohort study.
Pharmacoepidemiol Drug Saf. 2016 Feb; 25(2):123-32.PD

Abstract

PURPOSE

The study aimed to evaluate the comparative risk of oral ulcerations among antipsychotic medications.

METHODS

We analyzed the National Health Insurance Research Database of Taiwan and included patients newly initiated with a single antipsychotic agent including haloperidol, sulpiride, olanzapine, quetiapine, risperidone, or amisulpride during 2002 to 2010. The outcome of interest was oral ulceration, defined by the presence diagnoses of stomatitis and mucositis, aphthous-like ulceration and oral burns, or dispensing of stomatological corticosteroids included triamcinolone, dexamethasone, hydrocortisone, and prednisolone. We conducted Cox proportional hazards regression to compare the risks of oral ulceration among antipsychotics.

RESULTS

The rate of oral ulcerations was highest in the amisulpride group (217.7 per 1000 person-year), followed by quetiapine (193.9 per 1000 person-year), olanzapine (161.9 per 1000 person-year), sulpiride (147.1 per 1000 person-year), risperidone (115.6 per 1000 person-year), haloperidol (107.5 per 1000 person-year) and aripiprazole (49.8 per 1000 person-year). Compared with haloperidol users, the adjusted hazard ratio (AHR) was 1.40 (95% CI, 1.12-1.73) in olanzapine, 1.48 (95% CI, 1.30-1.69) in quetiapine, 1.27 (95% CI, 1.19-1.44) in sulpiride, 1.68 (95% CI, 0.97-2.59) in amisulpride, 1.02 (95% CI, 0.83-1.45) in risperidone, and 0.41 (95% CI, 0.24-0.72) in aripiprazole users by Cox regression model.

CONCLUSION

Olanzapine, quetiapine, and sulpiride posed a higher risk, while aripiprazole posed a lower risk of oral ulcerations compared with haloperidol in subjects with newly initiated antipsychotic therapy. Risperidone and amisulpride tended to have higher risk of oral ulcerations, but this was not statistically significant.

Authors+Show Affiliations

Duke Clinical Research Institute, Durham, NC, USA. Department of Medicine, Duke University School of Medicine, Durham, NC, USA. School of Pharmacy and Institute of Clinical Pharmacy and Pharmaceutical Sciences, National Cheng Kung University, Tainan, Taiwan. Health Outcome Research Center, National Cheng Kung University, Tainan, Taiwan.School of Pharmacy and Institute of Clinical Pharmacy and Pharmaceutical Sciences, National Cheng Kung University, Tainan, Taiwan. Department of Neurology, Tainan Sin-Lau Hospital, Tainan, Taiwan.Geriatric Medicine Unit, Massachusetts General Hospital, Boston, MA, USA.Department of Pharmacy Administration, College of Pharmacy, University of Illinois at Chicago, Chicago, IL, USA.Department of Psychiatry, National Cheng Kung University Hospital, Tainan, Taiwan. College of Medicine, National Cheng Kung University, Tainan, Taiwan.School of Pharmacy and Institute of Clinical Pharmacy and Pharmaceutical Sciences, National Cheng Kung University, Tainan, Taiwan. Health Outcome Research Center, National Cheng Kung University, Tainan, Taiwan.Duke Clinical Research Institute, Durham, NC, USA. Department of Medicine, Duke University School of Medicine, Durham, NC, USA.

Pub Type(s)

Comparative Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

26549190

Citation

Lai, Edward Chia-Cheng, et al. "Comparative Risk of Oral Ulcerations Among Antipsychotics Users - Population-based Retrospective Cohort Study." Pharmacoepidemiology and Drug Safety, vol. 25, no. 2, 2016, pp. 123-32.
Lai EC, Hsieh CY, Wong MB, et al. Comparative risk of oral ulcerations among antipsychotics users - population-based retrospective cohort study. Pharmacoepidemiol Drug Saf. 2016;25(2):123-32.
Lai, E. C., Hsieh, C. Y., Wong, M. B., Lin, S. J., Yang, Y. K., Kao Yang, Y. H., & Setoguchi, S. (2016). Comparative risk of oral ulcerations among antipsychotics users - population-based retrospective cohort study. Pharmacoepidemiology and Drug Safety, 25(2), 123-32. https://doi.org/10.1002/pds.3903
Lai EC, et al. Comparative Risk of Oral Ulcerations Among Antipsychotics Users - Population-based Retrospective Cohort Study. Pharmacoepidemiol Drug Saf. 2016;25(2):123-32. PubMed PMID: 26549190.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Comparative risk of oral ulcerations among antipsychotics users - population-based retrospective cohort study. AU - Lai,Edward Chia-Cheng, AU - Hsieh,Cheng-Yang, AU - Wong,Monera B, AU - Lin,Swu-Jane, AU - Yang,Yang-Kuang, AU - Kao Yang,Yea-Huei, AU - Setoguchi,Soko, Y1 - 2015/11/09/ PY - 2015/03/21/received PY - 2015/06/28/revised PY - 2015/09/24/accepted PY - 2015/11/10/entrez PY - 2015/11/10/pubmed PY - 2016/10/25/medline KW - antipsychotics KW - aripiprazole KW - olanzapine KW - oral health KW - pharmacoepidemiology KW - quetiapine KW - schizophrenia KW - sulpiride SP - 123 EP - 32 JF - Pharmacoepidemiology and drug safety JO - Pharmacoepidemiol Drug Saf VL - 25 IS - 2 N2 - PURPOSE: The study aimed to evaluate the comparative risk of oral ulcerations among antipsychotic medications. METHODS: We analyzed the National Health Insurance Research Database of Taiwan and included patients newly initiated with a single antipsychotic agent including haloperidol, sulpiride, olanzapine, quetiapine, risperidone, or amisulpride during 2002 to 2010. The outcome of interest was oral ulceration, defined by the presence diagnoses of stomatitis and mucositis, aphthous-like ulceration and oral burns, or dispensing of stomatological corticosteroids included triamcinolone, dexamethasone, hydrocortisone, and prednisolone. We conducted Cox proportional hazards regression to compare the risks of oral ulceration among antipsychotics. RESULTS: The rate of oral ulcerations was highest in the amisulpride group (217.7 per 1000 person-year), followed by quetiapine (193.9 per 1000 person-year), olanzapine (161.9 per 1000 person-year), sulpiride (147.1 per 1000 person-year), risperidone (115.6 per 1000 person-year), haloperidol (107.5 per 1000 person-year) and aripiprazole (49.8 per 1000 person-year). Compared with haloperidol users, the adjusted hazard ratio (AHR) was 1.40 (95% CI, 1.12-1.73) in olanzapine, 1.48 (95% CI, 1.30-1.69) in quetiapine, 1.27 (95% CI, 1.19-1.44) in sulpiride, 1.68 (95% CI, 0.97-2.59) in amisulpride, 1.02 (95% CI, 0.83-1.45) in risperidone, and 0.41 (95% CI, 0.24-0.72) in aripiprazole users by Cox regression model. CONCLUSION: Olanzapine, quetiapine, and sulpiride posed a higher risk, while aripiprazole posed a lower risk of oral ulcerations compared with haloperidol in subjects with newly initiated antipsychotic therapy. Risperidone and amisulpride tended to have higher risk of oral ulcerations, but this was not statistically significant. SN - 1099-1557 UR - https://www.unboundmedicine.com/medline/citation/26549190/Comparative_risk_of_oral_ulcerations_among_antipsychotics_users___population_based_retrospective_cohort_study_ L2 - https://doi.org/10.1002/pds.3903 DB - PRIME DP - Unbound Medicine ER -