Loading…
Risk of Psoriasis Following Terbinafine or Itraconazole Treatment for Onychomycosis: A Population-Based Case-Control Comparative Study
Introduction Several case studies have reported an association between antifungal drug use and psoriasis risk. Objective The objective of this study was to investigate the association between terbinafine/itraconazole exposure and psoriasis incidence. Methods Among patients with onychomycosis in the...
Saved in:
| Published in: | Drug safety 2018-03, Vol.41 (3), p.285-295 |
|---|---|
| Main Authors: | , , , , |
| Format: | Article |
| Language: | English |
| Subjects: | |
| Citations: | Items that this one cites Items that cite this one |
| Online Access: | Get full text |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| cited_by | cdi_FETCH-LOGICAL-c372t-595e0586d2ef72090a626104c9f85392411034c0a80ea820b23d6451e8a1af0d3 |
|---|---|
| cites | cdi_FETCH-LOGICAL-c372t-595e0586d2ef72090a626104c9f85392411034c0a80ea820b23d6451e8a1af0d3 |
| container_end_page | 295 |
| container_issue | 3 |
| container_start_page | 285 |
| container_title | Drug safety |
| container_volume | 41 |
| creator | Chiu, Hsien-Yi Chang, Wei-Lun Tsai, Tsen-Fang Tsai, Yi-Wen Shiu, Ming-Neng |
| description | Introduction
Several case studies have reported an association between antifungal drug use and psoriasis risk.
Objective
The objective of this study was to investigate the association between terbinafine/itraconazole exposure and psoriasis incidence.
Methods
Among patients with onychomycosis in the Taiwan National Health Insurance Research Database, 3831 incident psoriasis cases were identified during 2004–2010 and compared with 3831 age- and sex-matched controls with the same look-back period. Multivariate conditional logistic regression was used for the analysis.
Results
The psoriasis cases were significantly more likely than matched controls to have used terbinafine or itraconazole (59.85 vs. 42.70%, respectively;
p
360 days). In a comparison of patients receiving terbinafine or itraconazole only, psoriasis risk was higher for itraconazole (adjusted odds ratio 1.21, 95% confidence interval 1.05–1.40).
Conclusion
This large population-based case-control analysis showed that exposure to terbinafine or itraconazole is associated with an increased risk of incident psoriasis. The finding of an increased psoriasis risk for antifungal drug users, particularly for itraconazole, deserves attention in clinical practice although further prospective studies are necessary to confirm our findings and clarify the biological mechanisms that underlie these associations. |
| doi_str_mv | 10.1007/s40264-017-0614-2 |
| format | article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_journals_2194015433</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2194015433</sourcerecordid><originalsourceid>FETCH-LOGICAL-c372t-595e0586d2ef72090a626104c9f85392411034c0a80ea820b23d6451e8a1af0d3</originalsourceid><addsrcrecordid>eNp1kMtOwzAQRS0EEuXxAewssQ7MOM6LXYkoVKrUCsraMokDgdRT7ARUPoDvxlWRWLGZkWbuvaM5jJ0hXCBAdukliFRGgFkEKcpI7LERYlZEWEixz0aAYZgUmB6yI-9fASAXaT5i3_etf-PU8IUn12rfej6hrqPP1j7zpXFPrdVNaw0nx6e90xVZ_UWd4UtndL8ytudNWM3tpnqh1aaikHDFx3xB66HTfUs2utbe1LwMNSrJ9o46XtJqrV1Yfxj-0A_15oQdNLrz5vS3H7PHyc2yvItm89tpOZ5FVZyJPjyQGEjytBamyQQUoFORIsiqaPIkLoREhFhWoHMwOhfwJOI6lQmaXKNuoI6P2fkud-3ofTC-V680OBtOKhFIASYyjoMKd6rKkffONGrt2pV2G4WgtrjVDrcKuNUWtxLBI3YeH7T22bi_5P9NP6GKg0s</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2194015433</pqid></control><display><type>article</type><title>Risk of Psoriasis Following Terbinafine or Itraconazole Treatment for Onychomycosis: A Population-Based Case-Control Comparative Study</title><source>Springer Link</source><creator>Chiu, Hsien-Yi ; Chang, Wei-Lun ; Tsai, Tsen-Fang ; Tsai, Yi-Wen ; Shiu, Ming-Neng</creator><creatorcontrib>Chiu, Hsien-Yi ; Chang, Wei-Lun ; Tsai, Tsen-Fang ; Tsai, Yi-Wen ; Shiu, Ming-Neng</creatorcontrib><description>Introduction
Several case studies have reported an association between antifungal drug use and psoriasis risk.
Objective
The objective of this study was to investigate the association between terbinafine/itraconazole exposure and psoriasis incidence.
Methods
Among patients with onychomycosis in the Taiwan National Health Insurance Research Database, 3831 incident psoriasis cases were identified during 2004–2010 and compared with 3831 age- and sex-matched controls with the same look-back period. Multivariate conditional logistic regression was used for the analysis.
Results
The psoriasis cases were significantly more likely than matched controls to have used terbinafine or itraconazole (59.85 vs. 42.70%, respectively;
p
< 0.0001). After adjusting for potential confounders and cumulative duration of antifungal drug prescription, terbinafine/itraconazole use was associated with an increased psoriasis risk (adjusted odds ratio 1.33, 95% confidence interval 1.15–1.54). The association was stronger for more recent drug exposure (adjusted odds ratio 2.96, 95% confidence interval 2.25–3.90 for ≤ 90 days before the sampling date; adjusted odds ratio 1.04, 95% confidence interval 0.89–1.22 for > 360 days). In a comparison of patients receiving terbinafine or itraconazole only, psoriasis risk was higher for itraconazole (adjusted odds ratio 1.21, 95% confidence interval 1.05–1.40).
Conclusion
This large population-based case-control analysis showed that exposure to terbinafine or itraconazole is associated with an increased risk of incident psoriasis. The finding of an increased psoriasis risk for antifungal drug users, particularly for itraconazole, deserves attention in clinical practice although further prospective studies are necessary to confirm our findings and clarify the biological mechanisms that underlie these associations.</description><identifier>ISSN: 0114-5916</identifier><identifier>EISSN: 1179-1942</identifier><identifier>DOI: 10.1007/s40264-017-0614-2</identifier><language>eng</language><publisher>Cham: Springer International Publishing</publisher><subject>Antifungal agents ; Arthritis ; Bias ; Case studies ; Codes ; Comparative studies ; Confidence intervals ; Datasets ; Drug abuse ; Drug Safety and Pharmacovigilance ; Drug use ; Exposure ; Family medical history ; Fungicides ; Health insurance ; Health risk assessment ; Itraconazole ; Medicine ; Medicine & Public Health ; Onychomycosis ; Original Research Article ; Patients ; Pharmacology/Toxicology ; Population studies ; Population-based studies ; Psoriasis ; Regression analysis ; Risk ; Statistical analysis ; Terbinafine ; Tumor necrosis factor-TNF</subject><ispartof>Drug safety, 2018-03, Vol.41 (3), p.285-295</ispartof><rights>Springer International Publishing AG 2017</rights><rights>Copyright Springer Nature B.V. Mar 2018</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c372t-595e0586d2ef72090a626104c9f85392411034c0a80ea820b23d6451e8a1af0d3</citedby><cites>FETCH-LOGICAL-c372t-595e0586d2ef72090a626104c9f85392411034c0a80ea820b23d6451e8a1af0d3</cites><orcidid>0000-0002-0493-9707</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,777,781,27905,27906</link.rule.ids></links><search><creatorcontrib>Chiu, Hsien-Yi</creatorcontrib><creatorcontrib>Chang, Wei-Lun</creatorcontrib><creatorcontrib>Tsai, Tsen-Fang</creatorcontrib><creatorcontrib>Tsai, Yi-Wen</creatorcontrib><creatorcontrib>Shiu, Ming-Neng</creatorcontrib><title>Risk of Psoriasis Following Terbinafine or Itraconazole Treatment for Onychomycosis: A Population-Based Case-Control Comparative Study</title><title>Drug safety</title><addtitle>Drug Saf</addtitle><description>Introduction
Several case studies have reported an association between antifungal drug use and psoriasis risk.
Objective
The objective of this study was to investigate the association between terbinafine/itraconazole exposure and psoriasis incidence.
Methods
Among patients with onychomycosis in the Taiwan National Health Insurance Research Database, 3831 incident psoriasis cases were identified during 2004–2010 and compared with 3831 age- and sex-matched controls with the same look-back period. Multivariate conditional logistic regression was used for the analysis.
Results
The psoriasis cases were significantly more likely than matched controls to have used terbinafine or itraconazole (59.85 vs. 42.70%, respectively;
p
< 0.0001). After adjusting for potential confounders and cumulative duration of antifungal drug prescription, terbinafine/itraconazole use was associated with an increased psoriasis risk (adjusted odds ratio 1.33, 95% confidence interval 1.15–1.54). The association was stronger for more recent drug exposure (adjusted odds ratio 2.96, 95% confidence interval 2.25–3.90 for ≤ 90 days before the sampling date; adjusted odds ratio 1.04, 95% confidence interval 0.89–1.22 for > 360 days). In a comparison of patients receiving terbinafine or itraconazole only, psoriasis risk was higher for itraconazole (adjusted odds ratio 1.21, 95% confidence interval 1.05–1.40).
Conclusion
This large population-based case-control analysis showed that exposure to terbinafine or itraconazole is associated with an increased risk of incident psoriasis. The finding of an increased psoriasis risk for antifungal drug users, particularly for itraconazole, deserves attention in clinical practice although further prospective studies are necessary to confirm our findings and clarify the biological mechanisms that underlie these associations.</description><subject>Antifungal agents</subject><subject>Arthritis</subject><subject>Bias</subject><subject>Case studies</subject><subject>Codes</subject><subject>Comparative studies</subject><subject>Confidence intervals</subject><subject>Datasets</subject><subject>Drug abuse</subject><subject>Drug Safety and Pharmacovigilance</subject><subject>Drug use</subject><subject>Exposure</subject><subject>Family medical history</subject><subject>Fungicides</subject><subject>Health insurance</subject><subject>Health risk assessment</subject><subject>Itraconazole</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Onychomycosis</subject><subject>Original Research Article</subject><subject>Patients</subject><subject>Pharmacology/Toxicology</subject><subject>Population studies</subject><subject>Population-based studies</subject><subject>Psoriasis</subject><subject>Regression analysis</subject><subject>Risk</subject><subject>Statistical analysis</subject><subject>Terbinafine</subject><subject>Tumor necrosis factor-TNF</subject><issn>0114-5916</issn><issn>1179-1942</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><recordid>eNp1kMtOwzAQRS0EEuXxAewssQ7MOM6LXYkoVKrUCsraMokDgdRT7ARUPoDvxlWRWLGZkWbuvaM5jJ0hXCBAdukliFRGgFkEKcpI7LERYlZEWEixz0aAYZgUmB6yI-9fASAXaT5i3_etf-PU8IUn12rfej6hrqPP1j7zpXFPrdVNaw0nx6e90xVZ_UWd4UtndL8ytudNWM3tpnqh1aaikHDFx3xB66HTfUs2utbe1LwMNSrJ9o46XtJqrV1Yfxj-0A_15oQdNLrz5vS3H7PHyc2yvItm89tpOZ5FVZyJPjyQGEjytBamyQQUoFORIsiqaPIkLoREhFhWoHMwOhfwJOI6lQmaXKNuoI6P2fkud-3ofTC-V680OBtOKhFIASYyjoMKd6rKkffONGrt2pV2G4WgtrjVDrcKuNUWtxLBI3YeH7T22bi_5P9NP6GKg0s</recordid><startdate>20180301</startdate><enddate>20180301</enddate><creator>Chiu, Hsien-Yi</creator><creator>Chang, Wei-Lun</creator><creator>Tsai, Tsen-Fang</creator><creator>Tsai, Yi-Wen</creator><creator>Shiu, Ming-Neng</creator><general>Springer International Publishing</general><general>Springer Nature B.V</general><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>4T-</scope><scope>7RV</scope><scope>7T2</scope><scope>7TK</scope><scope>7U7</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>C1K</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><orcidid>https://orcid.org/0000-0002-0493-9707</orcidid></search><sort><creationdate>20180301</creationdate><title>Risk of Psoriasis Following Terbinafine or Itraconazole Treatment for Onychomycosis: A Population-Based Case-Control Comparative Study</title><author>Chiu, Hsien-Yi ; Chang, Wei-Lun ; Tsai, Tsen-Fang ; Tsai, Yi-Wen ; Shiu, Ming-Neng</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c372t-595e0586d2ef72090a626104c9f85392411034c0a80ea820b23d6451e8a1af0d3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Antifungal agents</topic><topic>Arthritis</topic><topic>Bias</topic><topic>Case studies</topic><topic>Codes</topic><topic>Comparative studies</topic><topic>Confidence intervals</topic><topic>Datasets</topic><topic>Drug abuse</topic><topic>Drug Safety and Pharmacovigilance</topic><topic>Drug use</topic><topic>Exposure</topic><topic>Family medical history</topic><topic>Fungicides</topic><topic>Health insurance</topic><topic>Health risk assessment</topic><topic>Itraconazole</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Onychomycosis</topic><topic>Original Research Article</topic><topic>Patients</topic><topic>Pharmacology/Toxicology</topic><topic>Population studies</topic><topic>Population-based studies</topic><topic>Psoriasis</topic><topic>Regression analysis</topic><topic>Risk</topic><topic>Statistical analysis</topic><topic>Terbinafine</topic><topic>Tumor necrosis factor-TNF</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Chiu, Hsien-Yi</creatorcontrib><creatorcontrib>Chang, Wei-Lun</creatorcontrib><creatorcontrib>Tsai, Tsen-Fang</creatorcontrib><creatorcontrib>Tsai, Yi-Wen</creatorcontrib><creatorcontrib>Shiu, Ming-Neng</creatorcontrib><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Docstoc</collection><collection>ProQuest Nursing and Allied Health Journals</collection><collection>Health and Safety Science Abstracts (Full archive)</collection><collection>Neurosciences Abstracts</collection><collection>Toxicology Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central</collection><collection>ProQuest Central</collection><collection>Environmental Sciences and Pollution Management</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><jtitle>Drug safety</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Chiu, Hsien-Yi</au><au>Chang, Wei-Lun</au><au>Tsai, Tsen-Fang</au><au>Tsai, Yi-Wen</au><au>Shiu, Ming-Neng</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Risk of Psoriasis Following Terbinafine or Itraconazole Treatment for Onychomycosis: A Population-Based Case-Control Comparative Study</atitle><jtitle>Drug safety</jtitle><stitle>Drug Saf</stitle><date>2018-03-01</date><risdate>2018</risdate><volume>41</volume><issue>3</issue><spage>285</spage><epage>295</epage><pages>285-295</pages><issn>0114-5916</issn><eissn>1179-1942</eissn><abstract>Introduction
Several case studies have reported an association between antifungal drug use and psoriasis risk.
Objective
The objective of this study was to investigate the association between terbinafine/itraconazole exposure and psoriasis incidence.
Methods
Among patients with onychomycosis in the Taiwan National Health Insurance Research Database, 3831 incident psoriasis cases were identified during 2004–2010 and compared with 3831 age- and sex-matched controls with the same look-back period. Multivariate conditional logistic regression was used for the analysis.
Results
The psoriasis cases were significantly more likely than matched controls to have used terbinafine or itraconazole (59.85 vs. 42.70%, respectively;
p
< 0.0001). After adjusting for potential confounders and cumulative duration of antifungal drug prescription, terbinafine/itraconazole use was associated with an increased psoriasis risk (adjusted odds ratio 1.33, 95% confidence interval 1.15–1.54). The association was stronger for more recent drug exposure (adjusted odds ratio 2.96, 95% confidence interval 2.25–3.90 for ≤ 90 days before the sampling date; adjusted odds ratio 1.04, 95% confidence interval 0.89–1.22 for > 360 days). In a comparison of patients receiving terbinafine or itraconazole only, psoriasis risk was higher for itraconazole (adjusted odds ratio 1.21, 95% confidence interval 1.05–1.40).
Conclusion
This large population-based case-control analysis showed that exposure to terbinafine or itraconazole is associated with an increased risk of incident psoriasis. The finding of an increased psoriasis risk for antifungal drug users, particularly for itraconazole, deserves attention in clinical practice although further prospective studies are necessary to confirm our findings and clarify the biological mechanisms that underlie these associations.</abstract><cop>Cham</cop><pub>Springer International Publishing</pub><doi>10.1007/s40264-017-0614-2</doi><tpages>11</tpages><orcidid>https://orcid.org/0000-0002-0493-9707</orcidid></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0114-5916 |
| ispartof | Drug safety, 2018-03, Vol.41 (3), p.285-295 |
| issn | 0114-5916 1179-1942 |
| language | eng |
| recordid | cdi_proquest_journals_2194015433 |
| source | Springer Link |
| subjects | Antifungal agents Arthritis Bias Case studies Codes Comparative studies Confidence intervals Datasets Drug abuse Drug Safety and Pharmacovigilance Drug use Exposure Family medical history Fungicides Health insurance Health risk assessment Itraconazole Medicine Medicine & Public Health Onychomycosis Original Research Article Patients Pharmacology/Toxicology Population studies Population-based studies Psoriasis Regression analysis Risk Statistical analysis Terbinafine Tumor necrosis factor-TNF |
| title | Risk of Psoriasis Following Terbinafine or Itraconazole Treatment for Onychomycosis: A Population-Based Case-Control Comparative Study |
| url | http://sfxeu10.hosted.exlibrisgroup.com/loughborough?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-19T18%3A42%3A10IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Risk%20of%20Psoriasis%20Following%20Terbinafine%20or%20Itraconazole%20Treatment%20for%20Onychomycosis:%20A%20Population-Based%20Case-Control%20Comparative%20Study&rft.jtitle=Drug%20safety&rft.au=Chiu,%20Hsien-Yi&rft.date=2018-03-01&rft.volume=41&rft.issue=3&rft.spage=285&rft.epage=295&rft.pages=285-295&rft.issn=0114-5916&rft.eissn=1179-1942&rft_id=info:doi/10.1007/s40264-017-0614-2&rft_dat=%3Cproquest_cross%3E2194015433%3C/proquest_cross%3E%3Cgrp_id%3Ecdi_FETCH-LOGICAL-c372t-595e0586d2ef72090a626104c9f85392411034c0a80ea820b23d6451e8a1af0d3%3C/grp_id%3E%3Coa%3E%3C/oa%3E%3Curl%3E%3C/url%3E&rft_id=info:oai/&rft_pqid=2194015433&rft_id=info:pmid/&rfr_iscdi=true |