TY - JOUR
T1 - Population-based study of risk of AKI with levetiracetam
AU - Yau, Kevin
AU - Burneo, Jorge G.
AU - Jandoc, Racquel
AU - McArthur, Eric
AU - Muanda, Flory Tsobo
AU - Parikh, Chirag R.
AU - Wald, Ron
AU - Weir, Matthew A.
AU - Garg, Amit X.
N1 - Funding Information:
This study was supported by the Institute for Clinical Evaluative Sciences (ICES) Western site. ICES is funded by an annual grant from the Ontario Ministry of Health and Long-Term Care (MOHLTC). Core funding for ICES Western is provided by the Academic Medical Organization of Southwestern Ontario (AMOSO), the Schulich School of Medicine and Dentistry (SSMD), Western University, and the Lawson Health Research Institute (LHRI). The authors thank IMS Brogan Inc. for use of their Drug Information Database. The research was conducted by members of the ICES Kidney, Dialysis, and Transplantation team, at the ICES Western facility, who are supported by a team grant from the Canadian Institutes of Health Research (CIHR). This specific project was funded through an operating grant from AMOSO. A.X.G. was supported by the Dr. Adam Linton Chair in Kidney Health Analytics and a CIHR Clinician Investigator Award. The opinions, results, and conclusions are those of the authors and are independent of the funding sources. No endorsement by ICES, AMOSO, SSMD, LHRI, or the MOHLTC is intended or should be inferred. Parts of this material are on the basis of data and/or information compiled and provided by the Canadian Institute for Health Information (CIHI). However, the analyses, conclusions, opinions, and statements expressed in the material are those of the authors, and not necessarily those of CIHI.
Publisher Copyright:
© 2019 by the American Society of Nephrology.
PY - 2019/1/7
Y1 - 2019/1/7
N2 - Background and objectives Regulatory agencies warn about the risk of AKI with levetiracetam use on the basis of information from case reports. We conducted this study to determine whether new levetiracetam use versus nonuse is associated with a higher risk of AKI. Design, setting, participants, & measurements This was a population-based retrospective cohort study of adults with epilepsy in Ontario, Canada. Patients who received a new outpatient prescription for levetiracetam between January 1, 2004 and March 1, 2017 were matched to two nonusers on stage of CKD, recorded seizure in the prior 90 days, and logit of a propensity score for levetiracetam use. The primary outcome was a hospital encounter (emergency department visit or hospitalization) with AKI within 30 days of cohort entry. Secondary outcomes were AKI within 180 days and change in the concentration of serum creatinine. We assessed the primary outcome using health care diagnosis codes. We evaluated the change in the concentration of serum creatinine in a subpopulation with laboratory measurements. Results We matched 3980 levetiracetam users to 7960 nonusers (mean age 55 years, 51% women). Levetiracetam use was not significantly associated with a higher risk of AKI within 30 days (13 [0.33%] events in levetiracetam users and 21 [0.26%] events in nonusers [odds ratio, 1.24; 95% confidence interval, 0.62 to 2.47]). Similarly, there was no significant association with AKI within 180 days (odds ratio, 0.70; 95% confidence interval, 0.43 to 1.13). The change in the concentration of serum creatinine did not significantly differ between levetiracetam users and nonusers. Conclusions In this population-based study levetiracetam use was not associated with a higher risk of AKI.
AB - Background and objectives Regulatory agencies warn about the risk of AKI with levetiracetam use on the basis of information from case reports. We conducted this study to determine whether new levetiracetam use versus nonuse is associated with a higher risk of AKI. Design, setting, participants, & measurements This was a population-based retrospective cohort study of adults with epilepsy in Ontario, Canada. Patients who received a new outpatient prescription for levetiracetam between January 1, 2004 and March 1, 2017 were matched to two nonusers on stage of CKD, recorded seizure in the prior 90 days, and logit of a propensity score for levetiracetam use. The primary outcome was a hospital encounter (emergency department visit or hospitalization) with AKI within 30 days of cohort entry. Secondary outcomes were AKI within 180 days and change in the concentration of serum creatinine. We assessed the primary outcome using health care diagnosis codes. We evaluated the change in the concentration of serum creatinine in a subpopulation with laboratory measurements. Results We matched 3980 levetiracetam users to 7960 nonusers (mean age 55 years, 51% women). Levetiracetam use was not significantly associated with a higher risk of AKI within 30 days (13 [0.33%] events in levetiracetam users and 21 [0.26%] events in nonusers [odds ratio, 1.24; 95% confidence interval, 0.62 to 2.47]). Similarly, there was no significant association with AKI within 180 days (odds ratio, 0.70; 95% confidence interval, 0.43 to 1.13). The change in the concentration of serum creatinine did not significantly differ between levetiracetam users and nonusers. Conclusions In this population-based study levetiracetam use was not associated with a higher risk of AKI.
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U2 - 10.2215/CJN.07490618
DO - 10.2215/CJN.07490618
M3 - Article
C2 - 30538089
AN - SCOPUS:85059928437
SN - 1555-9041
VL - 14
SP - 17
EP - 26
JO - Clinical Journal of the American Society of Nephrology
JF - Clinical Journal of the American Society of Nephrology
IS - 1
ER -