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WEDNESDAY, Nov. 13, 2019 (HealthDay News) — The incidence of encephalopathy is increased with prescription of higher versus lower doses of baclofen among older patients with chronic kidney disease (CKD), according to a study published online Nov. 9 in the Journal of the American Medical Association<\/i>. The research was published to coincide with Kidney Week, the annual meeting of the American Society of Nephrology, held from Nov. 5 to 10 in Washington, D.C.<\/p>\n
Flory T. Muanda, M.D., Ph.D., from the Institute for Clinical Evaluative Services in London, Ontario, Canada, and colleagues compared the 30-day incidence of encephalopathy among 15,942 older adults (\u226566 years) with CKD prescribed baclofen at a dose of either \u226520 mg\/day or <20 mg\/day (61 and 39 percent, respectively).<\/p>\n
The researchers found that hospitalization with encephalopathy occurred in 1.11 and 0.42 percent of patients who started baclofen at \u226520 mg\/day and <20 mg\/day, respectively (weighted risk ratio [RR], 3.54 [95 percent confidence interval (CI), 2.24 to 5.59]; weighted risk difference [RD], 0.80 percent [95 percent CI, 0.55 to 1.04 percent]). In a subgroup analysis, there was a progressive increase in absolute risk at lower estimated glomerular filtration rate (eGFR; weighted RD: eGFR 45 to 59: 0.42 percent [95 percent CI, 0.19 to 0.64 percent]; eGFR 30 to 44: 1.23 percent [95 percent CI, 0.62 to 1.84 percent]; eGFR <30: 2.90 percent [95 percent CI, 1.30 to 4.49 percent). In a secondary comparison with 284,263 nonusers, the risk for encephalopathy was significantly higher for both groups of baclofen users (\u226520 mg\/day: weighted RR, 19.8 [95 percent CI, 14.0 to 28.0]; <20 mg\/day: weighted RR, 5.90 [95 percent CI, 3.59 to 9.70]).<\/p>\n
“This population-based study of 15,942 older adults confirms and extends the findings of 30 international case reports linking baclofen use with encephalopathy in patients with CKD,” the authors write.<\/p>\n
One author disclosed financial ties to the pharmaceutical industry.<\/p>\n
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