Serotonin-norepinephrine Reuptake Inhibitors and Acute Kidney Injury (SNRI-AKI)

Canadian Network for Observational Drug Effect Studies, CNODES

Status: Completed

Conditions: Acute Kidney Injury; Depression

Treatments: Drug: Desvenlafaxine; Drug: Fluvoxamine; Drug: Fluoxetine; Drug: Citalopram; Drug: Paroxetine; Drug: Duloxetine; Drug: Venlafaxine; Drug: Sertraline; Drug: Escitalopram

Study type: Observational

Funder types: Other

Identifiers

NCT02320240

Q12-08

Details and patient eligibility

About

The purpose of this study is to determine if there is an excess risk of acute kidney injury (AKI) with Serotonin-norepinephrine reuptake inhibitors (SNRIs) as compared to Selective serotonin reuptake inhibitors (SSRIs), two classes of medication used for the treatment of depression.

Full description

We plan to conduct retrospective population-based cohort studies within eight administrative databases from Canada, the United States, and the United Kingdom. Within each cohort, a nested case-control analysis will be performed to estimate incidence rate ratios (RR) of AKI associated with SNRIs compared to SSRIs using conditional logistic regression, with adjustment for high-dimensional propensity scores at baseline. The overall effect across sites will then be estimated using meta-analytic methods.

Enrollment: 3,255,526 patients

Sex: All

Ages: 12+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• A first prescription of an antidepressant of the SNRI or SSRI class of any dose between January 1, 1997 and March 31, 2010.

Exclusion criteria

• They were <12 years old at the time of cohort entry.
• They had less than 1 year of information in the database prior to the date of cohort entry.
• They had a prescription of an SNRI or SSRI in the year before the date of cohort entry.
• They had a prescription for both an SNRI and an SSRI on the day of cohort entry.
• They had a history of chronic kidney disease (including kidney transplantation and dialysis) or AKI in the year preceding cohort entry.
• The subject was previously included in the cohort.

Trial design

3,255,526 participants in 2 patient groups

SNRI Exposure Group

Description:

Patients who received a new prescription for an SNRI (duloxetine, venlafaxine, or desvenlafaxine at any dosage) with no prescriptions for either SNRI or SSRI in the prior year.

Treatment:

Drug: Duloxetine

Drug: Desvenlafaxine

Drug: Venlafaxine

SSRI Exposure Group

Description:

Patients who received a new prescription for an SSRI (citalopram, escitalopram, fluoxetine, fluvoxamine, paroxetine, or sertraline at any dosage) with no prescriptions for either SSRI or SNRI in the prior year.

Treatment:

Drug: Paroxetine

Drug: Fluvoxamine

Drug: Citalopram

Drug: Fluoxetine

Drug: Escitalopram

Drug: Sertraline