NSAIDs, analgesics, antiplatelet drugs, and decline in renal function: a retrospective case-control study with SIDIAP database

We aim to explore the association between NSAIDs consumption, Symptomatic Slow Action Drugs for Osteoarthritis (SYSADOA), analgesics, and antiplatelet drugs, and decline in renal function by estimated Glomerular Filtration Rate (eGFR). We performed a case-control study using the SIDIAP database in C...

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Published in:	BMC pharmacology & toxicology Vol. 25; no. 1; p. 58
Main Authors:	Bonet-Monné, Sara, Urgell, Cristina Vedia, Sáez, M José Pérez, Puertolás, Oriol Cunillera, Baena-Díez, José Miguel, Pascual, Julio, Lago, Cristina Orive, Ruiz, Jordi Rodriguez, Gonzalez, Betlem Salvador, Pedrós, Rosa Morros
Format:	Journal Article
Language:	English
Published:	England BioMed Central Ltd 28-08-2024 BioMed Central
Subjects:	Acetaminophen Acetic acid Aged Aged, 80 and over Analgesics Analgesics - therapeutic use Analysis Anti-Inflammatory Agents, Non-Steroidal - therapeutic use Antiarthritic agents Case studies Case-Control Studies Confidence intervals Creatinine Databases, Factual Diabetes mellitus Drug dosages Drug use Epidermal growth factor receptors Ethics Etoricoxib Female Glomerular filtration rate Glomerular Filtration Rate - drug effects Humans Hypertension Kidney - drug effects Kidney - physiopathology Kidney diseases Male Middle Aged Narcotics Nonsteroidal anti-inflammatory drugs Opioids Organic acids Osteoarthritis Patients Pharmacy Platelet Aggregation Inhibitors - therapeutic use Prescription drugs Primary care Propionic acid Regression analysis Regression models Renal function Retrospective Studies Risk Spain - epidemiology Statistical analysis Triflusal Type 2 diabetes Variables Spain Platelet aggregation inhibitors Case control study Analgesics Anti-inflammatory agents Glomerular filtration rate
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Summary:	We aim to explore the association between NSAIDs consumption, Symptomatic Slow Action Drugs for Osteoarthritis (SYSADOA), analgesics, and antiplatelet drugs, and decline in renal function by estimated Glomerular Filtration Rate (eGFR). We performed a case-control study using the SIDIAP database in Catalonia. We considered defined cases, patients with an eGFR value ≤ 45 ml/min/1.73 m in the period 2010-2015 with a previous eGFR value ≥ 60, and no eGFR ≥ 60 after this period. Controls had an eGFR ≥ 60 with no previous eGFR < 60. Five controls were selected for each case, matched by sex, age, index date, Diabetes Mellitus and Hypertension. We estimated Odds Ratios (OR, 95% Confidence Intervals) of decline in renal function for drugs group adjusting with logistic regression models, by consumption measured in DDD. There were n = 18,905 cases and n = 94,456 controls. The mean age was 77 years, 59% were women. The multivariate adjusted model showed a low risk for eGFR decline for NSAIDs (0.92;0.88-0.97), SYSADOA (0.87;0.83-0.91) and acetaminophen (0.84;0.79-0.89), and an high risk for metamizole (1.07;1.03-1.12), and antiplatelet drugs (1.07;1.03-1.11). The low risk in NSAIDs was limited to propionic acid derivatives (0.92;0.88-0.96), whereas an high risk was observed for high doses in both acetic acid derivatives (1.09;1.03-1.15) and Coxibs (1.19;1.08-1.30). Medium and high use of major opioids shows a high risk (1.15;1.03-1.29). Triflusal showed high risk at medium (1.23;1.02-1.48) and high use (1.68;1.40-2.01). We observed a decline in renal function associated with metamizole and antiplatelet agent, especially triflusal, and with high use of acetic acid derivates, Coxibs, and major opioids. Further studies are necessary to confirm these results.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	2050-6511 2050-6511
DOI:	10.1186/s40360-024-00771-5