The following is a summary of “Prescribed Drug Use and Aneurysmal Subarachnoid Hemorrhage Incidence: A Drug-Wide Association Study,” published in the June 2024 issue of Neurology by Kanning et al.
Researchers conducted a retrospective drug-wide association study (DWAS) to identify links between commonly used medications and the incidence of aneurysmal subarachnoid hemorrhage (aSAH).
They identified all cases of aSAH (2000 and 2020) using International Classification of Disease codes from the Secure Anonymised Information Linkage databank. Each case was paired with 9 controls based on age, sex, and year of database entry. Commonly prescribed drugs (>2% in the study population) were examined and divided into 3 exposure windows relative to the most recent prescription before the index date (i.e., aSAH occurrence): current (within 3 months), recent (3–12 months), and past (>12 months). A logistic regression model compared drug use, adjusting for various factors. The family-wise error rate stayed below P<0.05 with Bonferroni correction.
The results showed exposure to 205 commonly prescribed drugs among 4,879 aSAH cases (mean age 61.4, 61.2% women) and 43,911 matched controls. Lisinopril and amlodipine displayed similar trends, with decreased aSAH risk for current use (lisinopril OR 0.63, 95% CI 0.44–0.90, amlodipine OR 0.82, 95% CI 0.65–1.04) and increased risk for recent use (lisinopril OR 1.30, 95% CI 0.61–2.78, amlodipine OR 1.61, 95% CI 1.04–2.48). Decreased aSAH risk was also found for current use of simvastatin (OR 0.78, 95% CI 0.64–0.96), metformin (OR 0.58, 95% CI 0.43–0.78), and tamsulosin (OR 0.55, 95% CI 0.32–0.93). Conversely, increased aSAH risk was observed for current use of warfarin (OR 1.35, 95% CI 1.02–1.79), venlafaxine (OR 1.67, 95% CI 1.01–2.75), prochlorperazine (OR 2.15, 95% CI 1.45–3.18), and co-codamol (OR 1.31, 95% CI 1.10–1.56).
Investigators concluded that while several medications were associated with aSAH risk, five drugs (lisinopril, amlodipine, simvastatin, metformin, and tamsulosin) showed a potential protective effect, warranting further investigation into their ability to reduce aSAH incidence.
Source: neurology.org/doi/10.1212/WNL.0000000000209479
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