Artikel
Sex-differences in the rate of adverse drug reactions associated with diuretics
Geschlechtsspezifische Unterschiede bei unerwünschten Arzneimittelwirkungen im Zusammenhang mit Diuretika
Suche in Medline nach
Autoren
Veröffentlicht: | 6. November 2008 |
---|
Gliederung
Text
Background and aim: From the database of the German Network of Regional Pharmacovigilance Centres (NRPZ) we have recently described that women experience more frequently ADRs associated with diuretics (Thürmann et al, Forum 2007), which could – in part – be explained by differences in prescribing. We therefore analysed sex-differences in diuretic prescribing.
Material and method: The database of the NRPZ consists of data from all patients admitted for ADRs in all internal medicine and emergency departments in the urban regions of Jena, Weimar, Greifswald, and Rostock, Germany. We analysed all ‘likely’ and ‘very likely’ ADRs caused by diuretics (ATC codes C03A-D plus combinations) between 2000 and 2006. Person-specific but non-identifying prescription data from a nationwide acting statutory health insurance company (GEK, about 1.6 Mio enrollees, 46% females) were analysed for the years 2000-2006 for the German federal states of Thuringia and Mecklenburg-Western Pomerania regarding age and sex specific prescription prevalences of diuretics. Sex-specific prescribing ratios were calculated and adjusted for the population in these regions.
Results: Diuretics caused serious ADRs in 375 patients, of which n = 258 occurred in women (68.8 vs 31.2 %, p <0.001). About 7% (MP) to 8% (TH) of the GEK enrollees received at least one diuretic prescription between 2000 and 2006. Among all age groups and all diuretic substance classes women were less likely to receive a diuretic prescription (MP: 6.7%; TH: 7.6%) than men (MP: 7.5%; TH: 8.5%). Sex-specific prescribing ratios (f:m) for enrollees aged 0 to 79 years varied between 0.8 (C03A/C03B, MP, 0-59y) and 1.3 (C03D, TH, 60-79y).
Conclusion: Available prescription data cannot explain the observed gender difference in the rate of ADRs with diuretics. However, a more detailed approach combining prescribing and ADR data and consideration of older age groups are required to substantiate our findings.
Supported by BfArM: Fo 2.1-68502-201
Prescription Data submitted by Gmuender ErsatzKasse (GEK)