Abstract | PURPOSE: METHODS: We conducted a population-based retrospective cohort study of Ontario residents with COPD aged 66 years or older who started treatment with valproic acid or phenytoin between 1 April 1993 and 30 November 2012. The primary outcome was a hospital admission or emergency department visit for a COPD exacerbation within 240 days of drug initiation. A secondary outcome examined initiation of oral corticosteroids in the outpatient setting. RESULTS: During the study period, we identified 4596 COPD patients who commenced valproic acid and 8478 who commenced phenytoin. Following multivariable adjustment, valproic acid did not increase the risk of the primary outcome (adjusted hazard ratio 1.00, 95% confidence interval 0.79 to 1.26). Although valproic acid was associated with a lower risk of initiating oral corticosteroids in the first thirty days following commencement of anticonvulsant therapy (adjusted hazard ratio 0.32; 95% confidence interval 0.21 to 0.49), no difference was observed during subsequent follow-up. CONCLUSION: Among older patients with COPD, treatment with valproic acid does not increase the risk of adverse pulmonary outcomes relative to phenytoin. These findings suggest that valproate-induced HDAC inhibition is of little clinical relevance in this context.
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Authors | Tony Antoniou, Zhan Yao, Ximena Camacho, Muhammad M Mamdani, David N Juurlink, Tara Gomes |
Journal | Pharmacoepidemiology and drug safety
(Pharmacoepidemiol Drug Saf)
Vol. 24
Issue 3
Pg. 256-61
(Mar 2015)
ISSN: 1099-1557 [Electronic] England |
PMID | 25656984
(Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
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Copyright | Copyright © 2015 John Wiley & Sons, Ltd. |
Chemical References |
- Anticonvulsants
- Valproic Acid
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Topics |
- Aged
- Aged, 80 and over
- Anticonvulsants
(administration & dosage, adverse effects)
- Cohort Studies
- Female
- Hospitalization
(trends)
- Humans
- Male
- Population Surveillance
(methods)
- Pulmonary Disease, Chronic Obstructive
(diagnosis, drug therapy, epidemiology)
- Retrospective Studies
- Valproic Acid
(administration & dosage, adverse effects)
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