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VIctoria Abbing PDF

223 Pages·2015·4.67 MB·English
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Understanding differences in findings from pharmacoepidemiological studies The case of antidepressant and benzodiazepine use and hip fracture Victoria Abbing-Karahagopian Funding Most of the studies in this thesis were conducted as part of the IMI-PROTECT consortium (Pharmacoepidemiological Research on Outcomes of Therapeutics by a European Con- sorTium, www.imi-protect.eu) which is a public-private partnership coordinated by the European Medicines Agency. The IMI-PROTECT project has received support from the Innovative Medicine Initiative Joint Undertaking (www.imi.europa.eu) under Grant Agreement n° 115004, resources of which are composed of financial contribution from the European Union’s Seventh Frame- work Programme (FP7/2007-2013) and EFPIA companies’ in kind contribution. In the context of the IMI Joint Undertaking (IMI JU), the Department of Pharmacoepidemiology and Clinical Pharmacology, Utrecht University, also received a direct financial contribution from Pfizer. The views expressed are those of the authors only and not of their respective institution or company. Printing of this thesis was kindly supported by the Nederlands Bijwerkingen Fonds [NBF, Dutch side effects fund]. ISBN: 978-94-6169-797-4 Layout and Printing: Optima Grafische Communicatie (www.ogc.nl) Cover painting by Arthur Pinajian 1914 – 1999. Courtesy of Pinajian Estate Collection (PinajianArt.com - http://pinajianart.com) Copyright © 2016 by V. Abbing-Karahagopian. The copyright of the articles that have been published has been transferred to the respective journals. Understanding differences in findings from PharmacoePidemiological stUdies the case of antidepressant and benzodiazepine use and hip fracture VariaBiliteit in Uitkomsten Van farmacoePidemiologisch onderzoek: de associatie tussen antidepressiva- en benzodiazepinegebruik en heupfracturen als casus (met een samenvatting in het Nederlands) Proefschrift ter verkrijging van de graad van doctor aan de Universiteit Utrecht op gezag van de rector magnificus, prof. dr. G.J. van der Zwaan, ingevolge het besluit van het college voor promoties in het openbaar te verdedigen op dinsdag 19 januari 2016 des middags te 12.45 uur door Victoria Abbing-Karahagopian geboren op 9 april 1971 te Beiroet, Libanon Promotoren: Prof. dr. A.C.G. Egberts Prof. dr. H.G.M. Leufkens Copromotoren: Dr. M.L. De Bruin Dr. T.P. van Staa In memory of one and a half million Armenians killed during the Genocide in 1915 by the Ottoman government. To future generations claiming their right for a dignified life, education and living their own culture. taBle of contents chapter 1 | introduction 9 1.1 General introduction 11 1.2 Bridging differences in outcomes of pharmacoepidemiological 25 studies: design and first results of the PROTECT project. chapter 2 | Variability in medication use patterns and health outcomes in europe 41 2.1 Antidepressant prescribing in five European countries: application of 43 common definitions to assess the prevalence, clinical observations and methodological implications. 2.2 Exposure to benzodiazepines and related drugs in seven European 59 electronic healthcare databases: a cross-national descriptive study from the PROTECT-EU Project 2.3 Incidence rates and trends of hip/femur fractures in five European 79 countries: comparison using e-healthcare records databases chapter 3 | Understanding findings of pharmacoepidemiological studies: complexity 95 of concomitant exposures 3.1 Understanding inconsistency in the results from observational 99 pharmacoepidemiological studies: the case of antidepressant use and risk of hip fracture 3.2 Concomitant medication use and its implications on the 125 hazard pattern in pharmacoepidemiological studies: example of antidepressants, benzodiazepines and fracture risk 3.3 Concomitant users of antidepressants and benzodiazepines: does 141 different timing of initiation modify the risk of osteoporotic fracture? chapter 4 | general discussion 157 chapter 5 | summary & samenvatting 181 appendices | Acknowledgements 201 List of co-authors 209 List of publications 215 About the author 221 1 Introduction chapter

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In memory of one and a half million Armenians killed during the Genocide in 1915 by the Ottoman government. Endocrinology. 2005;146(2):685-93. 54. Bliziotes M. Update in serotonin and bone. J. Clin Endocrinol Metabol. 2010;95(9):4124-32. 55. Verdel BM, Souverein PC, Egberts TC, van Staa.
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