Multi-country rapid adverse drug event assessment: the Asian Pharmacoepidemiology Network (AsPEN) antipsychotic and acute hyperglycaemia study

Authors

  • Nicole Pratt,

    1. Quality Use of Medicines and Pharmacy Research Centre, Sansom Institute for Health Research, University of South Australia, Adelaide, Australia
    Search for more papers by this author
  • Morten Andersen,

    1. Centre for Pharmacoepidemiology, Karolinska Institutet, and Division of Clinical Pharmacology, Department of Laboratory Medicine, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
    Search for more papers by this author
  • Ulf Bergman,

    1. Centre for Pharmacoepidemiology, Karolinska Institutet, and Division of Clinical Pharmacology, Department of Laboratory Medicine, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
    Search for more papers by this author
  • Nam-Kyong Choi,

    1. Medical Research Collaborating Centre, Seoul National University College of Medicine/Seoul National University Hospital, Seoul, Korea
    Search for more papers by this author
  • Tobias Gerhard,

    1. Institute for Health, Health Care Policy and Aging Research, Rutgers University, New Brunswick, NJ, USA
    2. Department of Pharmacy Practice and Administration, Ernest Mario School of Pharmacy, Rutgers University, Piscataway, NJ, USA
    Search for more papers by this author
  • Cecilia Huang,

    1. Institute for Health, Health Care Policy and Aging Research, Rutgers University, New Brunswick, NJ, USA
    Search for more papers by this author
  • Michio Kimura,

    1. Department of Medical Informatics, Hamamatsu University, School of Medicine, Shizuoka, Japan
    Search for more papers by this author
  • Tomomi Kimura,

    1. Department of Medical Informatics, Hamamatsu University, School of Medicine, Shizuoka, Japan
    Search for more papers by this author
  • Kiyoshi Kubota,

    1. Department of Pharmacoepidemiology, University of Tokyo Graduate School of Medicine, Tokyo, Japan
    Search for more papers by this author
  • Edward Chia-Cheng Lai,

    1. Institute of Clinical Pharmacy and Pharmaceutical Sciences, Health Outcome Research Centre, National Cheng Kung University, Tainan, Taiwan
    Search for more papers by this author
  • Nobuhiro Ooba,

    1. Department of Pharmacoepidemiology, University of Tokyo Graduate School of Medicine, Tokyo, Japan
    Search for more papers by this author
  • Urban Ösby,

    1. Neurogenetics Unit, Department of Molecular Medicine and Surgery, Karolinska Institutet, and Centre for Molecular Medicine, Stockholm, Sweden
    Search for more papers by this author
  • Byung-Joo Park,

    1. Department of Preventative Medicine, Seoul National University College of Medicine
    2. Medical Research Collaborating Centre, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Korea
    Search for more papers by this author
  • Tsugumichi Sato,

    1. Department of Pharmacoepidemiology, University of Tokyo Graduate School of Medicine, Tokyo, Japan
    Search for more papers by this author
  • Ju-Young Shin,

    1. Department of Preventative Medicine, Seoul National University College of Medicine
    Search for more papers by this author
  • Anders Sundström,

    1. Centre for Pharmacoepidemiology, Karolinska Institutet, and Division of Clinical Pharmacology, Department of Laboratory Medicine, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
    Search for more papers by this author
  • Yea-Huei Kao Yang,

    1. Institute of Clinical Pharmacy and Pharmaceutical Sciences, Health Outcome Research Centre, National Cheng Kung University, Tainan, Taiwan
    Search for more papers by this author
  • Elizabeth E Roughead

    Corresponding author
    • Quality Use of Medicines and Pharmacy Research Centre, Sansom Institute for Health Research, University of South Australia, Adelaide, Australia
    Search for more papers by this author

Correspondence to: E. Roughead, Quality Use of Medicines and Pharmacy Research Centre; Sansom Institute, University of South Australia, Adelaide, Australia. E-mail: libby.roughead@unisa.edu.au

ABSTRACT

Purpose

To undertake a multi-country study to investigate the risk of acute hyperglycaemia with antipsychotic use.

Methods

Using a distributed network model with a common minimal data set, we performed a prescription sequence symmetry analysis (PSSA) to investigate the risk of acute hyperglycaemia associated with antipsychotic initiation. Incident insulin prescriptions were used as a proxy indicator of acute hyperglycaemia. Participating countries and population datasets included Australia (300,000 persons), Japan I (300,000 persons), Japan II (200,000 persons), Korea (53 million persons) Taiwan (1 million persons), Sweden (9 million persons), USA-Public (87 million persons) and USA-Private (47 million persons).

Results

Olanzapine showed a trend towards increased risk in most databases, with a significant association observed in the USA-Public database (Adjusted sequence ratio (ASR) = 1.14; 95% Confidence Interval (CI) 1.10–1.17) and Sweden (ASR = 1.53; 95% CI 1.13–2.06). Null or negative associations were observed for haloperidol, quetiapine and risperidone.

Conclusion

Acute hyperglycaemia appears to be associated with olanzapine use, however, this effect was only observed in two large databases. Despite different patterns of utilization of both antipsychotics and insulin, PSSA analysis results for individual antipsychotic medicines were qualitatively similar across most countries. PSSA, used in conjunction with existing methods, may provide a simple and timely method further supporting multi-national drug safety monitoring. Copyright © 2013 John Wiley & Sons, Ltd.

Ancillary