TABLE 4.
Dose–response analysis of associations between the α1‐adrenoceptor antagonist use, and AD
| Median group of cumulative DDD | AD cases N = 24 602 | Controls N = 98 397 | Unadjusted OR (95% CI) | Adjusted a OR (95% CI) | Adjusted b OR (95% CI) | |
|---|---|---|---|---|---|---|
| Tamsulosin use c | ||||||
| Lag time only | First (30–540 DDD) | 3197 (54.8) | 9884 (50.8) | 1.00 (reference) | 1.00 (reference) | Not applicable |
| Second (546–2700 DDD) | 2633 (45.2) | 9583 (49.2) | 0.86 (0.78–0.94) | 0.85 (0.78–0.93) | Not applicable | |
| Before lag time | First (30–270 DDD) | 3684 (52.0) | 12 741 (52.0) | 1.00 (reference) | 1.00 (reference) | 1.00 (reference) |
| Second (300–4350 DDD) | 3406 (48.0) | 11 753 (48.0) | 1.00 (0.93–1.08) | 0.99 (0.92–1.06) | 0.98 (0.91–1.06) | |
| Any exposure | First (30–360 DDD) | 4717 (51.2) | 15 959 (51.0) | 1.00 (reference) | 1.00 (reference) | 1.00 (reference) |
| Second (370–5670 DDD) | 4495 (48.8) | 15 310 (49.0) | 0.99 (0.93–1.05) | 0.98 (0.92–1.04) | 0.98 (0.92–1.04) | |
| Alfuzosin use | ||||||
| Lag time only | First (20–360 DDD) | 1023 (52.9) | 3360 (53.1) | 1.00 (reference) | 1.00 (reference) | Not applicable |
| Second (362.67–3040 DDD) | 910 (47.1) | 2968 (46.9) | 1.15 (0.90–1.46) | 1.13 (0.88–1.46) | Not applicable | |
| Before lag time | First (20–160 DDD) | 949 (52.8) | 3197 (53.9) | 1.00 (reference) | 1.00 (reference) | 1.00 (reference) |
| Second (180–4560 DDD) | 850 (47.3) | 2740 (46.2) | 1.03 (0.81–1.31) | 1.04 (0.81–1.33) | 1.00 (0.77–1.29) | |
| Any exposure | First (20–200 DDD) | 1435 (48.5) | 4979 (50.9) | 1.00 (reference) | 1.00 (reference) | 1.00 (reference) |
| Second (209–7040 DDD) | 1526 (51.5) | 4804 (49.1) | 1.14 (0.97–1.34) | 1.12 (0.95–1.32) | 1.10 (0.93–1.31) | |
Note: Users of more than median DDDs are compared to users of less than median DDDs in different time categories. Lag time refers to 0–3 years before the index date. Any exposure is the combined exposure during actual exposure assessment period (before lag time) and during the lag time.
Adjusted for highest occupational class, cardiovascular disease, stroke, diabetes, asthma or COPD, cataract, acute cancer, inpatient care with psychiatric diagnoses, substance abuse, use of benzodiazepines and related drugs, antidepressants, antipsychotics and 5‐alpha reductase inhibitors, and categorized sum of purchased drugs in 1995.
Adjusted for abovementioned confounders and mediators (categorized sum of hospital admissions, outpatient visits and new drugs [excluding α1‐adrenoceptor antagonists] during the lag time).
Including the use of tamsulosin and dutasteride combination.