TY - JOUR
T1 - Association between methylphenidate and risk of myocardial infarction
T2 - A multinational self-controlled case series study
AU - Jeong, Han Eol
AU - Lee, Hyesung
AU - Lai, Edward Chia-Cheng
AU - Liao, Tzu-Chi
AU - Man, Kenneth K C
AU - Wong, Ian C K
AU - Coghill, David
AU - Chi, Mei-Hung
AU - Hsieh, Cheng-Yang
AU - Shin, Ju-Young
N1 - Funding Information:
National Health Insurance Service-National Health Insurance Database (NHIS-2020-1-010) was provided by the National Health Insurance Service of South Korea. We thank the administrative and technical supports from the Health Data Science Centre, National Cheng Kung University Hospital, Tainan, Taiwan.
Funding Information:
H.E.J reports receipt of research funding from the National Research Foundation of South Korea, outside the submitted work. E.C.C.L. reports receipt of research funding from Taiwan's Ministry of Science and Technology, grants from pharmaceutical companies including Amgen and Takeda, outside the submitted work. K.K.C.M reports receipt of research funding from the CW Maplethorpe Fellowship; grants from the United Kingdom National Institute for Health Research; the Hong Kong Research Grant Council; and personal fees from IQVIA, outside the submitted work. I.C.K.W reports receipt of research funding from the Research Grant Council, Hong Kong, during the conduct of the study; and personal fees from Medice and grants and personal fees from Janssen, outside the submitted work. D.C. reports receipt of research funding and personal fees from Shire/Takeda and personal fees from Medice, Novartis, and Oxford University Press, outside the submitted work. J.Y.S. reports receipt of research funding from the Ministry of Food and Drug Safety, Ministry of Health and Welfare, National Research Foundation, and Government‐wide R&D Fund for Infectious Disease Research of South Korea; grants from pharmaceutical companies including Amgen, Pfizer, Hoffmann‐La Roche, Dong‐A ST, Yungjin, outside the submitted work. No other disclosures were reported.
Publisher Copyright:
© 2021 John Wiley & Sons Ltd.
PY - 2021/10
Y1 - 2021/10
N2 - PURPOSE: To investigate the association between use of methylphenidate and risk of myocardial infarction among Asians.METHODS: We conducted a multinational self-controlled case series study using nationwide healthcare databases of South Korea (2002-2018), Taiwan (2004-2015), and Hong Kong (2001-2016). Of patients with myocardial infarction who were also prescribed methylphenidate within the observation period, methylphenidate use was classified into four mutually exclusive periods by each person-day: exposed (exposed to methylphenidate), pre-exposure (prior to the first methylphenidate prescription), washout (after the end of methylphenidate treatment), and baseline (unexposed to methylphenidate). Risk of myocardial infarction among the three periods of methylphenidate use was compared to the baseline period using conditional Poisson regression analysis to estimate incidence rate ratios (IRRs) with 95% confidence intervals (CIs).RESULTS: We identified 2104, 484, and 30 patients from South Korea, Taiwan, and Hong Kong, respectively. Risk of myocardial infarction was the highest during the pre-exposure period in all three populations: South Korea, pre-exposure (IRR 3.17, 95% CI 3.04-3.32), exposed (1.05, 1.00-1.11), washout (1.92, 1.80-2.04); Taiwan, pre-exposure (1.97, 1.78-2.17), exposed (0.72, 0.65-0.80), washout (0.56, 0.46-0.68); Hong Kong, pre-exposure (18.09, 8.19-39.96), exposed (9.32, 3.44-25.28), washout (7.69, 1.72-34.41). Following stratification for age and sex, the trends remained analogous to the main findings across all three populations.CONCLUSIONS: Although a positive association between initiating methylphenidate and the onset of myocardial infarction was observed, the risk was the highest in the period before its initiation. Thus, this multinational study suggests there was no causal relationship between methylphenidate and myocardial infarction among Asians.
AB - PURPOSE: To investigate the association between use of methylphenidate and risk of myocardial infarction among Asians.METHODS: We conducted a multinational self-controlled case series study using nationwide healthcare databases of South Korea (2002-2018), Taiwan (2004-2015), and Hong Kong (2001-2016). Of patients with myocardial infarction who were also prescribed methylphenidate within the observation period, methylphenidate use was classified into four mutually exclusive periods by each person-day: exposed (exposed to methylphenidate), pre-exposure (prior to the first methylphenidate prescription), washout (after the end of methylphenidate treatment), and baseline (unexposed to methylphenidate). Risk of myocardial infarction among the three periods of methylphenidate use was compared to the baseline period using conditional Poisson regression analysis to estimate incidence rate ratios (IRRs) with 95% confidence intervals (CIs).RESULTS: We identified 2104, 484, and 30 patients from South Korea, Taiwan, and Hong Kong, respectively. Risk of myocardial infarction was the highest during the pre-exposure period in all three populations: South Korea, pre-exposure (IRR 3.17, 95% CI 3.04-3.32), exposed (1.05, 1.00-1.11), washout (1.92, 1.80-2.04); Taiwan, pre-exposure (1.97, 1.78-2.17), exposed (0.72, 0.65-0.80), washout (0.56, 0.46-0.68); Hong Kong, pre-exposure (18.09, 8.19-39.96), exposed (9.32, 3.44-25.28), washout (7.69, 1.72-34.41). Following stratification for age and sex, the trends remained analogous to the main findings across all three populations.CONCLUSIONS: Although a positive association between initiating methylphenidate and the onset of myocardial infarction was observed, the risk was the highest in the period before its initiation. Thus, this multinational study suggests there was no causal relationship between methylphenidate and myocardial infarction among Asians.
KW - Asian population
KW - methylphenidate
KW - multinational study
KW - myocardial infarction
KW - self-controlled case series
UR - http://www.scopus.com/inward/record.url?scp=85109588302&partnerID=8YFLogxK
U2 - 10.1002/pds.5322
DO - 10.1002/pds.5322
M3 - Article
C2 - 34216049
SN - 1053-8569
VL - 30
SP - 1458
EP - 1467
JO - Pharmacoepidemiology and Drug Safety
JF - Pharmacoepidemiology and Drug Safety
IS - 10
ER -