ArticleDrugs & aging2017
Atypical Antipsychotics and the Risks of Acute Kidney Injury and Related Outcomes Among Older Adults: A Replication Analysis and an Evaluation of Adapted Confounding Control Strategies.
Article in Drugs & aging, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 3 of them syntheses that pooled it.
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The trial behind it
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Who cites it
7 citing papers in PubMed, 3 syntheses or guidelines pooled it, 14 citations in OpenAlex.
- Risk of renal impairment in atypical antipsychotics: a systematic review and meta-analysis.European journal of clinical pharmacology · 2024Pooled it
- Psychotropic Drugs and Adverse Kidney Effects: A Systematic Review of the Past Decade of Research.CNS drugs · 2022Pooled it
- Biological substantiation of antipsychotic-associated pneumonia: Systematic literature review and computational analyses.PloS one · 2017Pooled it
- Innovations in pharmacovigilance studies of medicines in older people.British journal of clinical pharmacology · 2025Review
- Multiple adverse outcomes associated with antipsychotic use in people with dementia: population based matched cohort study.BMJ (Clinical research ed.) · 2024Article
- Incidence of hospital contacts with acute kidney injury after initiation of second-generation antipsychotics in older adults: a Danish population-based cohort study.European journal of clinical pharmacology · 2022Article
- How Confident Are We about Observational Findings in Healthcare: A Benchmark Study.Harvard data science review · 2020Article
Corrections and comments
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Authors and funding
4 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveA recently published analysis of population-based claims data from Ontario, Canada reported higher risks of acute kidney injury (AKI) and related outcomes among older adults who were new users of atypical antipsychotics (AAPs) compared with unexposed patients. In light of these findings, the objective of the current study was to further investigate the risks of AKI and related outcomes among older adults receiving AAPs.
methodsA replication of the previously published analysis was performed using the US Truven MarketScan Medicare Supplemental database (MDCR) among patients aged 65 years and older. Compared with non-users of AAPs, the study compared the risk of AKI and related outcomes with users of AAPs (quetiapine, risperidone, olanzapine, aripiprazole, or paliperidone) using a 1-to-1 propensity score matched analysis. In addition, we performed adapted analyses that: (1) included all covariates used to fit propensity score models in outcome models; and (2) required patients to have a diagnosis of schizophrenia, bipolar disorder, or major depression and a healthcare visit within 90 days prior to the index date.
resultsAKI effect estimates [as odds ratios (ORs) with 95% confidence intervals (CIs)] were significantly elevated in our MDCR replication analyses (OR 1.45, 95% CI 1.32-1.60); however, in adapted analyses, associations were not significant (OR 0.91, 95% CI 0.78-1.07)). In analyses of AKI and related outcomes, results were mostly consistent between the previously published and the MDCR replication analyses. The primary change that attenuated associations in adapted analyses was the requirement for patients to have a mental health condition and a healthcare visit prior to the index date.
conclusionsThe MDCR analysis yielded similar results when the methodology of the previously published analysis was replicated, but, in adapted analyses, we did not find significantly higher risks of AKI and related outcomes. The contrast of results between our replication and adapted analyses may be due to the analytic approach used to compare patients (and potential confounding by indication). Further research is warranted to evaluate these associations, while also examining methods to account for differences in older adults who do and do not use these medications.
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