| アブストラクト | AIM: The aim of the present study was to describe the occurrence and determinants of angiotensin-converting enzyme (ACE) inhibitor (ACEI) intolerance and angioedema (AE) among patients initiating ACEI therapy in a real-world primary care population. METHODS: Two nested case-control studies were conducted in a cohort of 276 977 patients aged >/=45 years initiating ACEIs from 2007 to 2014 in the UK Clinical Practice Research Datalink (CPRD). Cases of AE occurring for the first time during ACEI therapy (n = 416) were matched with AE-free controls (n = 4335) on the duration of ACEI treatment. Documented switches to angiotensin-II receptor blockers in the prescription records were used to identify ACEI-intolerance cases (n = 24 709), and these were matched with continuous ACEI users (n = 84 238) on the duration of ACEI therapy. Conditional logistic regression was used to assess the associations of demographic factors, comorbidities and comedication with AE and ACEI intolerance. RESULTS: AE during ACEI therapy was associated with age over 65 years [odds ratio (OR) 1.36, 95% confidence interval (CI) 1.07, 1.73], history of allergy (OR 1.53, 95% CI 1.19, 1.96), use of calcium channel blockers (OR 1.57, 95% CI 1.23; 2.01), use of antihistamines (OR 21.25, 95% CI 16.44, 27.46) and use of systemic corticosteroids (OR 4.52, 95% CI 3.26, 6.27). ACEI intolerance was significantly associated with more comorbidities and comedication compared with AE, including allergy (OR 2.02, 95% CI 1.96, 2.09), use of antiasthmatic drugs (OR 1.51, 95% CI 1.42, 1.61) and use of antihistamines (OR 1.53, 95% CI 1.43, 1.63). CONCLUSIONS: Among ACEI users developing AE or ACEI intolerance, several comorbidities and comedication classes were significantly more prevalent compared with ACEI users not developing these adverse reactions. |
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| ジャーナル名 | British journal of clinical pharmacology |
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| Pubmed追加日 | 2016/8/16 |
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| 投稿者 | Mahmoudpour, Seyed Hamidreza; Baranova, Ekaterina Vitalievna; Souverein, Patrick C; Asselbergs, Folkert W; de Boer, Anthonius; Maitland-van der Zee, Anke Hilse |
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| 組織名 | Utrecht Institute for Pharmaceutical Sciences (UIPS), Division of;Pharmacoepidemiology and Clinical Pharmacology, Utrecht University, Utrecht, The;Netherlands.;Department of Cardiology, Division Heart and Lungs, University Medical Centre;Utrecht, Utrecht, The Netherlands.;Durrer Center for Cardiogenetic Research, ICIN-Netherlands Heart Institute,;Utrecht, The Netherlands.;Institute of Cardiovascular Science, faculty of Population Health Sciences,;University College London, London, UK. |
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| Pubmed リンク | https://www.ncbi.nlm.nih.gov/pubmed/27524468/ |
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