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Published March 18, 2021 | Version v1
Dataset Open

Data from: Antiepileptic drug use and mortality among community-dwelling persons with Alzheimer's disease

Creators

  • 1. University of Eastern Finland
  • 2. Karolinska Institute

Description

Objective: To evaluate the risk of death in relation to incident antiepileptic drug use compared with non-use in people with Alzheimer's disease (AD) through the assessment in terms of duration of use, specific drugs and main causes of death. Methods: The MEDALZ cohort includes all Finnish persons who received a clinically verified AD diagnosis (N=70718) in 2005‒2011. Incident AED users were identified with 1-year washout period. For each incident AED user (n=5638) one non-user was matched according to sex, age and time since AD diagnosis. Analyses were conducted with Cox proportional hazards models and inverse probability of treatment weighting (IPTW). Results: Nearly 50% discontinued AEDs within six months. Compared with non-users, AED users had an increased relative risk of death (IPTW hazard ratio (HR): 1.23; 95% CI: 1.12‒1.36). This was mainly due to deaths from dementia (IPTW HR: 1.62, 95% CI: 1.42‒1.86). There was no difference in cardio- and cerebrovascular deaths (IPTW HR: 0.98, 95% CI: 0.67‒1.44). The overall mortality was highest during the first 90 days of AED use (IPTW HR: 2.40, 95% CI: 1.91‒3.03). Among users of older AEDs relative risk of death was greater compared to users of newer AED use (IPTW HR: 1.79, 95% CI: 1.52‒2.16). Conclusions: In old vulnerable population with cognitive disorder, careful consideration of AED initiation and close adverse events monitoring are needed.

Notes

Contents of supplementary files: Figure 1(a-b) K-M curves for the whole and restricted to 3 years follow-up periods Figure 2 (a-h) K-M curves for drug-drug comparison for the whole sample with the follow-up restricted to 3 years Table 1 Definitions for exclusion criteria Table 2 Definitions and classifications of baseline covariates Table 3 Differences in baseline characteristics between AED users with and without matched non-users Table 4 Characteristics of the study sample of persons with Alzheimer's disease according to the use of antiepileptic drugs Table 5 Characteristics of the antiepileptic drug users by type of antiepileptic drug Table 6 Causes of death Table 7 Association between type of antiepileptic drug and dementia deaths by type of AED (follow-up is restricted to 3 years) Table 8 Association between antiepileptic use and mortality overall and stratified by causes of death in persons without epilepsy  (follow-up is restricted to 3 years) Figure 3 K-M curve for persons without epilepsy Table 9 Causes of death in persons without epilepsy (group of non-users is composed of different matching persons compared to the previous whole sample) Table 10 Association of antiepileptic use and all cause mortality stratified by follow-up time in persons without epilepsy (follow-up is restricted to 3 years) Table 11 Association between type of antiepileptic drug and all cause mortality by type of AED in persons without epilepsy (follow-up is restricted to 3 years) Figure 4 K-M curves for drug-drug comparison in persons without epilepsy with the follow-up restricted to 3 years.

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