Risk of hospitalization for acute hepatitis in patients treated with non-benzodiazepine hypnosedatives: case-crossover study from the National Health Insurance in Taiwan
Date Issued
2007
Date
2007
Author(s)
Tsan, Yu-Tse
Abstract
Introduction: With extensive use of hypnosedatives worldwide, in addition to the most commonly reported side effects of sedation, liver injury induced by benzodiazepines (BZDs) has been reported and should be monitored. BZDs, zolpidem and zopiclone all undergo hepatic metabolism. Hepatoxicity has been suspected so the aim of this study was to determine the association between the use of BZDs, zolpidem, zopiclone and the risk of hospitalization related to acute hepatitis.ethods: The study cohort dataset was obtained from the National Health Insurance (NHI) research database in Taiwan from 1997-2004. We separated the groups of patients diagnosed before selected admission of outpatient visits or hospitalization as viral hepatitis B, C, non-viral, non-alcoholic hepatitis, alcoholic hepatitis. Since there were so many determinants, or potential confounders for acute hepatitis, we applied case-crossover design as a means of controlling factors within subjects.esults: 45,626 cases of hospitalization relating to acute hepatitis were obtained. The odds ratio for the first week was the largest and most significant for these medicines. Conditional logistic regression analysis showed a significant adjusted odds ratio of 2.4 (95% confidence interval 1.9, 3.0) for zolpidem during the 7-day risk period. The adjusted odds ratio of zopiclone was 1.5 (95% confidence interval 1.0, 2.4) during the 7-day exposure period. In BZDs, the results were similar to the previous two drugs. In addition, based on the trend of the adjusted odds ratios, another peak was found during the 3 to 6-week period.iscussion: There is an increased risk of hospitalization for acute hepatitis in patients treated with zolpidem, zopiclone and benzodiazepines, and most severe drug induced liver injuries can be idiosyncratic and dose-independent. Thus, physicians and clinical pharmacists should take such potential into consideration and monitor the liver function of patients taking hypnosedatives suspected to be hepatotoxic.
Subjects
pharmacoepidemialogy, National Health Insurance File and NHI Major Disease File
benzodiazepine
zolpidem
zopiclone
hepatotoxicity
hypnosedative.
SDGs
Type
thesis
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