Comparison of cardiovascular events among treatments for overactive bladder: a Danish nationwide cohort study

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Purpose: The purpose of this study is to explore the cardiovascular safety of antimuscarinic drugs to treat overactive bladder (OAB) in Denmark. Methods: This was a cohort study using data recorded in Danish registries from patients newly exposed to darifenacin, fesoterodine, oxybutynin, solifenacin, tolterodine, or trospium in 2004–2012. We estimated crude and standardized incidence rates (IRs) for acute myocardial infarction (AMI); stroke; cardiovascular mortality; major adverse cardiac events (MACE, a combined endpoint of the previous three outcomes); and all-cause death for the individual and combined drugs. We also estimated crude, standardized, and propensity score-stratified incidence rate ratios (IRRs) comparing individual antimuscarinic drugs to tolterodine as the reference. Results: Among 72,917 new users of OAB drugs (mean age, 66 years; 60% women), the standardized IR (95% confidence interval) per 1000 person-years for current use of any OAB drug was 2.7 (2.5–2.9) for AMI, 1.3 (1.2–1.5) for stroke, 7.8 (7.5–8.1) for MACE, 4.8 (4.5–5.0) for cardiovascular mortality, and 15.2 (14.8–15.6) for all-cause mortality. Propensity score-stratified IRRs for current use (reference, tolterodine) were close to the null for all drugs and endpoints. Conclusions: We did not identify differences in the risk of cardiovascular events or mortality among users of individual antimuscarinic OAB drugs.

LanguageEnglish
JournalEuropean Journal of Clinical Pharmacology
Volume74
Issue number2
Pages (from-to)193-199
ISSN0031-6970
DOIs
Publication statusPublished - 2018

    Research areas

  • Cardiovascular diseases, Denmark, Muscarinic antagonists, Pharmacoepidemiology, Urinary bladder, overactive