TY - JOUR AB - Purpose: Due to conflicting scientific evidence for an increased risk of dementia by intake of proton pump inhibitors (PPIs), this study investigates associations between PPI use and brain volumes, estimated brain age, and cognitive function in the general population. Methods: Two surveys of the population-based Study of Health in Pomerania (SHIP) conducted in Northeast Germany were used. In total, 2653 participants underwent brain magnetic resonance imaging (MRI) and were included in the primary analysis. They were divided into two groups according to their PPI intake and compared with regard to their brain volumes (gray matter, white matter, total brain, and hippocampus) and estimated brain age. Multiple regression was used to adjust for confounding factors. Cognitive function was evaluated by the Verbal Learning and Memory Test (VLMT) and the Nuremberg Age Inventory (NAI) and put in relation to PPI use. Results: No association was found between PPI use and brain volumes or the estimated brain age. The VLMT score was 1.11 lower (95% confidence interval: − 2.06 to − 0.16) in immediate recall, and 0.72 lower (95% CI: − 1.22 to − 0.22) in delayed recall in PPI users than in non-users. PPI use was unrelated to the NAI score. Conclusions: The present study does not support a relationship between PPI use and brain aging. AU - Ahn, N. AU - Frenzel, S.* AU - Wittfeld, K.* AU - Bülow, R.* AU - Völzke, H.* AU - Lerch, M.M.* AU - Chenot, J.F.* AU - Schminke, U.* AU - Nolde, M. AU - Amann, U. AU - Meisinger, C. AU - Linseisen, J. AU - Grabe, H.J.* AU - Rückert-Eheberg, I.-M. C1 - 61024 C2 - 50018 CY - Tiergartenstrasse 17, D-69121 Heidelberg, Germany SP - 1039-1048 TI - Lack of association between proton pump inhibitor use and brain aging: A cross-sectional study. JO - Eur. J. Clin. Pharmacol. VL - 77 IS - 7 PB - Springer Heidelberg PY - 2021 SN - 0031-6970 ER - TY - JOUR AB - Purpose: The German annual drug prescription-report has indicated overuse of proton pump inhibitors (PPIs) for many years; however, little was known about the characteristics of people using PPIs. This study aimed to provide comprehensive utilization data and describe frequencies of potential on- and off-label PPI-indications in Bavaria, Germany. Methods: Claims data of statutorily insured people from 2010 to 2018 were used. Defined daily doses (DDDs) of PPIs by type of drug, prevalence of PPI-use and DDDs prescribed per 1000 insured people/day were analyzed. For 2018, proportions of users and DDDs per 1000 insured people were calculated by age and sex. To elucidate changes in prescribing practices due to a suspected drug-drug interaction, we examined co-prescribing of clopidogrel and PPIs between 2010 and 2018. For PPI new users, sums of DDDs and frequencies of potential indications were examined. Results: PPI prescribing increased linearly from 2010 to 2016 and gradually decreased from 2016 to 2018. In 2018, 14.7% of women and 12.2% of men received at least one prescription, and 64.8 DDDs (WHO-def.) per 1000 insured people/day were prescribed. Overall, omeprazole use decreased over the observation period and was steadily replaced by pantoprazole, especially when co-prescibed with clopidogrel. An on-label PPI-indication was not reported at first intake in 52.0% of new users. Conclusions: The utilization of prescribed PPIs has decreased since 2016. However, a large proportion of new PPI-users had no documentation of a potential indication, and the sums of DDDs prescribed often seemed not to comply with guidelines. AU - Rückert-Eheberg, I.-M. AU - Nolde, M.* AU - Ahn, N.* AU - Tauscher, M.* AU - Gerlach, R.* AU - Güntner, F.* AU - Günter, A.* AU - Meisinger, C.* AU - Linseisen, J. AU - Amann, U. AU - Baumeister, S.E.* C1 - 63767 C2 - 51623 CY - Tiergartenstrasse 17, D-69121 Heidelberg, Germany TI - Who gets prescriptions for proton pump inhibitors and why? A drug-utilization study with claims data in Bavaria, Germany, 2010–2018. JO - Eur. J. Clin. Pharmacol. PB - Springer Heidelberg PY - 2021 SN - 0031-6970 ER - TY - JOUR AB - PURPOSE: The purpose of this study was to compare longitudinal data on drug utilization between 10-year-old children and 15-year-old adolescents and to analyse the association of drug use at the age of 15 years with drug use at the age of 10 years. METHODS: Based on the German GINIplus (German infant study on the Influence of Nutrition Intervention plus environmental and genetic influences on allergy development) and LISAplus (Influence of lifestyle factors on the immune system and allergies in East and West Germany plus the influence of traffic emissions and genetics) birth cohorts, data on drug utilization (past 4 weeks) were collected using a self-administered questionnaire for 3642 children (10-year follow-up) and 4677 adolescents (15-year follow-up). The drugs were classified by therapeutic categories (conventional drugs, homeopathic drugs, etc.) and by codes according to the anatomical therapeutic chemical (ATC) classification system. Associations of adolescents' drug use with gender, study area, maternal education, parental income, presence of chronic conditions, and prior drug use at the age of 10 years were analysed using a logistic regression model. RESULTS: The 4-week prevalence rates of overall drug use were similar for adolescents (41.1 %) and children (42.3 %). However, adolescents used noticeably more anti-inflammatory drugs, analgesics, and systemic antihistamines. Exactly 3194 children/adolescents participated in both follow-ups. Adolescents' use of anti-inflammatory drugs was predicted (OR = 3.37) by use of anti-inflammatory drugs as a child. In summary, the strongest predictor of adolescents' use of specific therapeutic categories or ATC groups was the previous use of the same therapeutic drug category or ATC group as a 10-year-old child. CONCLUSIONS: Despite similar prevalence rates of overall drug utilization among both age groups, there is a noticeable difference concerning the use of drugs from specific ATC groups. Drug use as a child may partly determine what they use as an adolescent. AU - Italia, S. AU - Brüske, I. AU - Heinrich, J. AU - Berdel, D.* AU - von Berg, A.* AU - Lehmann, I.* AU - Standl, M. AU - Wolfenstetter, S.B. C1 - 47345 C2 - 39313 CY - Heidelberg SP - 301-310 TI - A longitudinal comparison of drug use among 10-year-old children and 15-year-old adolescents from the German GINIplus and LISAplus birth cohorts. JO - Eur. J. Clin. Pharmacol. VL - 72 IS - 3 PB - Springer Heidelberg PY - 2016 SN - 0031-6970 ER - TY - JOUR AB - Purpose The purpose of this drug utilization study was to describe the use of rivaroxaban in Germany during a time period in which approval was limited to the prevention of venous thromboembolism following hip or knee replacement. Additionally, we explored the feasibility of reconstructing inpatient drug use of rivaroxaban in a database where with a few exceptions inpatient prescribing information is not available. Methods Source of data was one statutory health insurance providing data on about seven million insurants throughout Germany. Analyses were based on a cohort of rivaroxaban users from launch (October 2008) to December 2009 and encompassed potential indications for rivaroxaban use, treatment duration, and co-prescribing of potentially interacting drugs. Start of rivaroxaban treatment was defined by the date of surgery. Results During the study period, 425 rivaroxaban users were identified contributing 440 treatment periods. For more than 82 % of these episodes labelled indications could be determined. Treatment durations exceeded recommendations in 95 % of the episodes following knee replacement whereas rivaroxaban use after elective hip surgery was found to be longer than recommended in 56 %. Prescribing of potentially interacting medication was rare except for non-steroidal anti-inflammatory drugs. Conclusions Overall, no important off-label use of rivaroxaban was identified. Based on several assumptions that have to be considered in the interpretation of the results our study describes a database approach to reconstruct inpatient drug use for a drug started after a coded hospital procedure, when treatment continues after hospital discharge and no change in drug use is expected in the outpatient setting. AU - Jobski, K.* AU - Amann, U. AU - Suzart, K.* AU - Wallander, M.A.* AU - Schink, T.* AU - Garbe, E.* C1 - 31579 C2 - 34582 CY - Heidelberg SP - 975-981 TI - Use of rivaroxaban in Germany: A database drug utilization study of a drug started in hospital. JO - Eur. J. Clin. Pharmacol. VL - 70 IS - 8 PB - Springer Heidelberg PY - 2014 SN - 0031-6970 ER - TY - JOUR AB - The efficacy of extended release felodipine 10 mg (ER) o.d., a new dihydropyridine calcium antagonist, and 25 mg hydrochlorothiazide (HCTZ) o.d. have been compared in a randomized, double-blind, crossover trial in 28 mildly to moderately hypertensive subjects (supine diastolic blood pressure, BP, greater than or equal to 95 mm Hg and less than or equal to 110 mm Hg on three separate occasions). Both drugs significantly reduced systolic and diastolic BP in the sitting position felodipine from 157.1/93.8 mm Hg at baseline to 133/78.9 mm Hg 2.5 h after medication and to 138/82.7 mm Hg after 2 weeks of treatment, and HCTZ from 156/95.6 mm Hg to 147/88.4 mm Hg 2.5 h after medication and to 149/89.5 mm Hg also after 2 weeks. A decrease of the same magnitude in standing systolic and diastolic BP was observed after both treatment regimens with the exception of diastolic BP 2.5 h after dosing with HCTZ, which was not significantly lower. At all times (2.5 h and 2 weeks), the reduction in systolic and diastolic BP was greater after felodipine compared to HCTZ. Heart rate was significantly increased after felodipine in both the sitting and standing positions, and both 2.5 h following medication and after 2 weeks of treatment. The difference between the regimens was significant only 2.5 h after dosing. Overall, felodipine 10 mg ER o.d. was superior to 25 mg HCTZ o.d. in lowering BP. AU - Koenig, W. AU - Sund, M. AU - Binner, L. AU - Hehr, R. AU - Rosenthal, J. AU - Hombach, V. C1 - 19538 C2 - 12637 SP - 197-199 TI - Comparison of Once Daily Felodipine 10 mg ER and Hydrochlorothiazide 25 mg in the Treatment of Mild to Moderate Hypertension. JO - Eur. J. Clin. Pharmacol. VL - 41 IS - 3 PY - 1991 SN - 0031-6970 ER - TY - JOUR AB - In the MONICA Augsburg project, a cohort of 3324 men and women randomly selected from the population (aged 30 to 64 y) was surveyed in 1984/85 and in 1987/88. Their antihypertensive medication as well as their demographic characteristics, blood pressure values, and awareness of hypertension were assessed at each visit in an identical manner. In 1984/85 the prevalence of antihypertensive drug use in the cohort was 7.8% (n = 260). In 1987/88, 204 of the hypertensives were still being treated (continuously treated hypertensives) and there were 167 newly treated hypertensives, thus increasing the prevalence of antihypertensive drug use to 11.2%. Of the 204 continuously treated hypertensives, 45.6% had changed their antihypertensive medication over the three-year follow-up period. Combinations with diuretics (except those containing calcium antagonists or ACE-inhibitors) had largely been discontinued, and the prevalence of calcium antagonist mono- and combination therapy had markedly increased from 84/85 to 87/88. Men were treated more frequently with recently introduced antihypertensive agents than women. Newly treated hypertensives (n = 167) showed antihypertensive treatment patterns reflecting the changes observed in continuously treated hypertensives. Triple drug combinations, mostly in fixed ratios, were being taken by approximately 25% of all hypertensives at each visit. Prospective analysis revealed an underlying discontinuation rate of 49%. It is concluded that the epidemiology of antihypertensive therapy in individuals and in the community is subject to rapid changes and various influences. Cohort studies of treated antihypertensive individuals offer a more comprehensive understanding of its determinants. AU - Hense, H.-W. AU - Tennis, P. C1 - 18952 C2 - 11340 SP - 1-7 TI - Changing Patterns of Antihypertensive Drug Use in a German Population Between 1984 and 1987. Results of a Population Based Cohort Study in the Federal Republic of Germany. JO - Eur. J. Clin. Pharmacol. VL - 39 IS - 1 PY - 1990 SN - 0031-6970 ER - TY - JOUR AU - Hense, H.W. AU - Tennis, P.S. C1 - 42544 C2 - 40259 SP - 496 TI - Changing patterns of antihypertensive drug use in a population between 1984 and 1987. Results from a population based cohort study. JO - Eur. J. Clin. Pharmacol. VL - 12 IS - 3 PY - 1990 SN - 0031-6970 ER - TY - JOUR AB - In the MONICA Augsburg project, a cohort of 3324 men and women randomly selected from the population (aged 30 to 64 y) was surveyed in 1984/85 and in 1987/88. Their antihypertensive medication as well as their demographic characteristics, blood pressure values, and awareness of hypertension were assessed at each visit in an identical manner. In 1984/85 the prevalence of anti-hypertensive drug use in the cohort was 7.8% (n = 260). In 1987/88, 204 of the hypertensives were still being treated (continuously treated hypertensives) and there were 167 newly treated hypertensives, thus increasing the prevalence of antihypertensive drug use to 11.2%. Of the 204 continuously treated hypertensives, 45.6% had changed their antihypertensive medication over the three-year follow-up period. Combinations with diuretics (except those containing calcium antagonists or ACE-inhibitors) had largely been discontinued, and the prevalence of calcium antagonist mono- and combination therapy had markedly increased from 84/85 to 87/88. Men were treated more frequently with recently introduced antihypertensive agents than women. Newly treated hypertensives (n = 167) showed antihypertensive treatment patterns reflecting the changes observed in continuously treated hypertensives. Triple drug combinations, mostly in fixed ratios, were being taken by approximately 25% of all hypertensives at each visit. Prospective analysis revealed an underlying discontinuation rate of 49%. It is concluded that the epidemiology of antihypertensive therapy in individuals and in the community is subject to rapid changes and various influences. Cohort studies of treated antihypertensive individuals offer a more comprehensive understanding of its determinants. AU - Hense, H.W. AU - Tennis, P.S. C1 - 42546 C2 - 40195 SP - 1-7 TI - Changing patterns of antihypertensive drug use in a german population between 1984 and 1987 - Originals Results of a population based cohort study in the Federal Republic of Germany. JO - Eur. J. Clin. Pharmacol. VL - 39 IS - 1 PY - 1990 SN - 0031-6970 ER - TY - JOUR AB - A study has been done to describe and compare the drug utilization profiles of the 30-64 yr-old populations in two cities in the Federal Republic of Germany. Subjects from two community surveys, based on random samples in 1984, from the communities of Augsburg in the south, and Luebeck in the north, were asked to bring to interview any medications taken in the preceding seven days. Total drug use in the two communities was very similar. Women took more drugs than men. The drug categories used by at least 5% of men were analgesics/antirheumatics and antihypertensives. The prevalence of use of different drug categories by men was remarkably similar in the two cities, and the only significant difference was a greater consumption of antihypertensive drugs by Luebeck men (9.8%) compared to Augsburg men (6.3%). The drugs taken by at least 5% of women were sex hormones, analgesics/antirheumatics, antihypertensives, thyroid preparations, psychotropics, cardiac drugs and antihypotensives. Consumption by Augsburg women was significantly greater for sex hormones, cardiac drugs, thyroid drugs, and migraine drugs, whereas Luebeck women consumed significantly more antihypertensives. The high use of thyroid drugs by Augsburg women (11%) is indicative of the high frequency of endemic goitre in the southeastern quarter of the FRG. Although it has been shown from sales data that the FRG has a high consumption of cardiac glycosides, the 6% prevalence of use of preparations of them by 30-64 yrold Augsburg women represents more precise exposure information and reflects a relatively young group of users. AU - Tennis, P.S. C1 - 33618 C2 - 36409 SP - 447-452 TI - Drug utilization by the 30-64 year-old people in two cities in the Federal Republic of Germany in 1984. JO - Eur. J. Clin. Pharmacol. VL - 38 IS - 5 PY - 1990 SN - 0031-6970 ER - TY - JOUR AB - Psychotropic drug intake by a random sample of citizens of the city of Munich aged 30-69 years has been assessed. A 1-week prevalence of 9.3% for all psychotropic drug users was found, benzodiazepines accounting for approximately two-thirds (6.6%) of the users. Two-thirds of drug users were women. Drug use in both sexes increased with age. The doses of benzodiazepines prescribed in most cases were less than 10 mg diazepam equivalent per day. Intake of benzodiazepines in combination with analgesics or alcohol (≥40 g/day) did not appear to represent a major problem. Multiple logistic regression analysis showed that the number of chronic diseases was the strongest predictor of benzodiazepine intake in men, whereas stress and age determined intake in women. Long-term use seemed to be relatively rare at 11% of all benzodiazepine users, so it was not considered to be a severe public health problem. AU - Koenig, W. AU - Rüther, E. AU - Filipiak, B. C1 - 41642 C2 - 36249 SP - 43-51 TI - Psychotropic drug utilization patterns in a metropolitan population. JO - Eur. J. Clin. Pharmacol. VL - 32 IS - 1 PY - 1987 SN - 0031-6970 ER - TY - JOUR AB - The inhibitory effect of triamterene and its metabolites on human leucocyte dihydrofolate reductase has been studied. Under test conditions with dihydrofolic acid 0.5×10-5 M, triamterene 7×10-5 M produced total enzyme inhibition, whereas the metabolites hydroxytriamterene and the sulphate ester of hydroxytriamterene were less effective inhibitors; at their maximum attainable concentration of 5×10-5 M, dihydrofolate reductase was inhibited by 80% and 50%, respectively. Cultures of the BJAB-B95-8 human lymphoma cell line were incubated with various concentrations of triamterene. Because of their increased specific activity of dihydrofolate reductase, the cells were able to maintain normal DNA metabolism, as measured by the ratio of the incorporation rates of 3H-deoxyuridine and 3H-thymidine, as well as normal cell growth at 1×10-6 M, and in some cases at 1 × 10-5 M triamterene. At 8×10-5 M triamterene, the strong inhibitory effect caused severe impairment of DNA metabolism and subsequently dissolution of the cell culture. The results are discussed in relation to the possible toxic side effects of long-term triamterene treatment in patients suffering from alcoholic cirrhosis, who may have impaired metabolism of triamterene and a concomitant severe folate deficiency. AU - Schalhorn, A.* AU - Siegert, W.* AU - Sauer, H.J. C1 - 41585 C2 - 38529 SP - 219-224 TI - Antifolate effect of triamterene on human leucocytes and on a human lymphoma cell line. JO - Eur. J. Clin. Pharmacol. VL - 20 IS - 3 PY - 1981 SN - 0031-6970 ER -