Real-World Evidence of Indapamide-Induced Rhabdomyolysis: A
Retrospective Analysis of Electronic Health Records
Abstract
Purpose: This study aims to investigate the potential causal
relationship between the use of indapamide and rhabdomyolysis. Previous
research and pharmacovigilance monitoring activities have suggested a
potential association between indapamide use and rhabdomyolysis.
However, limited information is available on this association.
Methods: A case-control study conducted using EHR data, between
July 1,2016, and December 31,2022. Patients who have rhabdomyolysis
event (cases) were matched to four controls bases on age, gender and
date. We examined the odds for indapamide exposure through three risk
periods: current use, recent use, and former. The study outcome was
ascertained through the presence of CK level over 1,000 U/L (i.e.
rhabdomyolysis event). Subsequently, a multivariable conditional
logistic regression analysis was utilized to assess the causal impact of
indapamide exposure on the likelihood of developing rhabdomyolysis,
while accounting for potential confounding variables. Results:
The study population consisted of 2,965 cases and 11,860 controls. The
results of the conditional logistic regression analysis indicated a lack
of association between exposure to indapamide for the current users the
OR was 0.7 (95% CI: 0.49 - 0.92) and the AOR was 0.6 (95% CI: 0.39 -
1.05). The recent users showed OR of 0.9 (95% CI: 0.56 - 1.50) and AOR
of 0.2 (95% CI: 0.14 - 0.47). Lastly, the former users demonstrated an
OR of 0.8 (95% CI: 0.47 - 1.26), and AOR of 0.1 (95% CI: 0.07 - 0.23).
Conclusions: In this study, we did not find association between
indapamide use and rhabdomyolysis regardless timing of exposure.