Supplementary Materials Supplemental Desk 6 ASN

Supplementary Materials Supplemental Desk 6 ASN. higher (citalopram or escitalopram) versus lower (fluoxetine, fluvoxamine, paroxetine or sertraline) QT-prolongingCpotential SSRIs would have a higher risk CP 465022 hydrochloride of sudden cardiac death. Methods This study was approved by the University of North Carolina at Chapel Hill Institutional Review Board (#17C0011). A waiver of consent was granted due to the studys large size, data anonymity, and retrospective nature. Data Source The data source for this study was the US Renal Data System (USRDS) database. The USRDS is a national ESRD surveillance system that collects, analyzes, and distributes information on individuals with ESRD in the United States. The USRDS database includes the Medical Evidence and ESRD Death Notification CP 465022 hydrochloride Forms as well as Medicare standard analytic files, including the Medicare enrollment database and final action administrative claims (Medicare Parts A, B, and D). Study Design and Population We conducted a retrospective cohort study using an active comparator new-user design25 (Figure 1) to investigate the association between the initiation of higher (citalopram or escitalopram) versus lower (fluoxetine, fluvoxamine, paroxetine, or sertraline) QT-prolongingCpotential SSRIs and the 1-year risk of sudden cardiac death among individuals receiving maintenance hemodialysis. First, we identified hemodialysis patients with Medicare coverage (Parts A, B, and D) who newly initiated SSRI therapy from January 1, 2007 to December 30, 2014 after a 180-day washout period free of documented SSRI use. To be included Rabbit polyclonal to ZFP2 in the study, SSRI new-users had to receive in-center hemodialysis during the 180 days before SSRI initiation (blocker11,442 (37.0%)13,114 (37.8%)2.111,562 (37.4%)12,981 (37.4%)0.0Calcium channel blocker8768 (28.3%)10,385 (29.9%)5.59031 (29.2%)10,141 (29.2%)0.0Central agonist3906 (12.6%)4413 (12.7%)0.73913 (12.7%)4394 (12.7%)0.0Diuretic2903 (9.4%)3565 (10.3%)9.53048 (9.9%)3420 (9.8%)0.1Use of 1 1 medication with a known risk of TdPc2919 (9.4%)3210 (9.2%)2.22891 (9.3%)3244 (9.3%)0.1Use of 1 1 medication with a conditional risk of TdPc12,634 (40.8%)14,238 (41.0%)0.412,675 (41.0%)14,231 (41.0%)0.0Use of 1 1 medication with a possible risk of TdPc3228 (10.4%)3123 (9.0%)15.63001 (9.7%)3375 (9.7%)0.1Use of 1 1 CYP 1A2 inhibitord1154 (3.7%)1290 (3.7%)0.51155 (3.7%)1296 (3.7%)0.1Use of 1 1 CYP 3A4 inhibitord2419 (7.8%)2770 (8.0%)2.12450 (7.9%)2746 (7.9%)0.2Use of 1 1 CP 465022 hydrochloride CYP 2C9 inhibitord2074 (6.7%)2385 (6.9%)2.62104 (6.8%)2360 (6.8%)0.1Use of 1 1 CYP 2C19 inhibitord8119 (26.2%)9022 (26.0%)1.08095 (26.2%)9087 (26.2%)0.0Use of 1 1 CYP 2D6 inhibitord8777 (28.4%)9999 (28.8%)1.58845 (28.6%)9931 (28.6%)0.0Hospitalized during the last 30 d of the baseline period8701 (28.1%)8749 (25.2%)11.28248 (26.7%)9264 (26.7%)0.0Had 1 psychotherapy visit during the baseline period3314 (10.7%)2738 (7.9%)31.82859 (9.2%)3211 (9.2%)0.0 Open in a separate window Values are given as number (percentage) for categoric variables and as meanSD for continuous variables. Higher QT-prolongingCpotential SSRIs included escitalopram and citalopram. Decrease QT-prolongingCpotential SSRIs included fluoxetine, fluvoxamine, paroxetine, and sertraline. All covariates had been measured through the 180-d baseline period before SSRI initiation. The weighted cohort may be the pseudo-population generated from the IPT weighting. Std diff, standardized variations; ACE, angiotensin-converting enzyme; ARB, angiotensin receptor blocker; TdP, torsades de pointes; CYP, cytochrome P450. aA std diff 10.0% signifies meaningful imbalance between organizations.33 bThe definition of low-dose was based on the dosing recommendations found in each SSRIs package insert.62C67 Low doses: citalopram20 mg/d; escitalopram10 mg/d; fluoxetine20 mg/d; immediate release fluvoxamine 50 mg/d; controlled release fluvoxamine 100 mg/d; immediate release paroxetine 20 mg/d; controlled release paroxetine 25 mg/d; and sertraline 50 mg/d. cLists of medications with known, conditional, and possible risks of TdP are presented in Supplemental Desk 3. dLists of medicines which are relevant CYP 1A2, 3A4, 2C9, 2C19, and 2D6 inhibitors are given in Supplemental Desk 4..