| アブストラクト | BACKGROUND: Whether leukotriene receptor antagonist (LTRA) or inhaled corticosteroid (ICS) use can increase the risk of self-harm remains unclear. OBJECTIVE: To evaluate the association between self-harm and use of LTRAs and ICSs among patients with asthma. METHODS: This self-controlled case series study used data from the UK Clinical Practice Research Datalink linked to hospital and mortality records. We included patients with asthma aged 10 years or more who had at least 1 prescription of LTRA, 1 prescription of ICS, and an incident self-harm during the period 2005 to 2020. Incidence rate ratios (IRRs) of self-harm during periods of (presented in order of precedence if they overlapped) pre-LTRA, pre-ICS, LTRA-alone, ICS-alone, and combination use of LTRA and ICS, versus nonuse, were calculated using conditional Poisson regression model. Additional analyses using self-controlled case series extension, case-case-time-control, and cohort study designs were used to examine robustness of results. RESULTS: Among 313,943 individuals prescribed LTRAs and ICSs, 2900 had incident self-harm. IRRs were 0.77 (95% CI, 0.58-1.01) during pre-LTRA, 0.68 (95% CI, 0.57-0.82) during LTRA-alone, and 0.70 (95% CI, 0.56-0.86) during combination use. Further analysis suggested that the self-harm incidence was lower during the first 90 days of LTRA use (IRR, 0.74; 95% CI, 0.58-0.95), before returning to nonuse level (IRR, 0.93; 95% CI, 0.74-1.17). Comparable incidence to nonuse was observed during pre-ICS (IRR, 0.99; 95% CI, 0.71-1.39) and ICS-alone (IRR, 0.88; 95% CI, 0.75-1.04). The results were robust across sensitivity analyses and study designs, which did not suggest increased risk of self-harm with LTRA/ICS use. CONCLUSIONS: Using the self-controlled case series design, which was based on comparisons within a population with both the outcome and exposure of interest, our study does not support an association between self-harm and LTRA or ICS use in patients with asthma. |
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| ジャーナル名 | The journal of allergy and clinical immunology. In practice |
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| Pubmed追加日 | 2025/9/30 |
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| 投稿者 | Chen, Boqing; Yuen, Andrew S C; Man, Kenneth K C; Hayes, Joseph F; Osborn, David P J; Wong, Ian C K; Chan, Adrienne Y L; Cheng, Lok Yin; Jani, Yogini H; Lau, Wallis C Y |
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| 組織名 | Research Department of Practice and Policy, UCL School of Pharmacy, London,;United Kingdom; Centre for Medicines Optimisation Research and Education,;University College London Hospitals NHS Foundation Trust, London, United Kingdom.;University College London Hospitals NHS Foundation Trust, London, United Kingdom;;Laboratory of Data Discovery for Health (D24H), Hong Kong Science Park, Pak Shek;Kok, Hong Kong; Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of;Medicine, University of Hong Kong, Hong Kong.;Division of Psychiatry, University College London, London, United Kingdom; Camden;and Islington NHS Foundation Trust, London, United Kingdom.;Medicine, University of Hong Kong, Hong Kong; School of Pharmacy, Medical;Sciences Division, Macau University of Science and Technology, Taipa, Macau;;Advance Data Analytics for Medical Science Limited, Hong Kong; School of;Pharmacy, Aston University, Birmingham, United Kingdom.;Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine,;University of Hong Kong, Hong Kong; School of Pharmacy, Aston University,;Birmingham, United Kingdom.;Respiratory Medicine, University Hospitals Birmingham NHS Foundation Trust,;Medicine, University of Hong Kong, Hong Kong. Electronic address:;wallis.lau@ucl.ac.uk. |
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| Pubmed リンク | https://www.ncbi.nlm.nih.gov/pubmed/41022320/ |
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