Association of orexin receptor antagonists with falls during hospitalization.

Rintaro Sogawa, Akiko Emoto, Akira Monji, Yuki Miyamoto, Misako Yukawa, Toru Murakawa-Hirachi, Yasuhiro Tagomori, Mikiko Kawasaki, Shinya Kimura, Chisato Shimanoe

Journal of clinical pharmacy and therapeutics 2022 Jun

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The use of hypnotics, especially benzodiazepines (BZs), increases the risk of falls. Regarding the association of orexin receptor antagonists with fall risk, consistent results have not been obtained for suvorexant, and studies of lemborexant have not been reported. Therefore, this study investigated whether orexin receptor antagonists, including lemborexant, increase the risk of falls. Data were obtained from the medical records of patients hospitalized at Saga University Hospital in Japan between July 2020 and April 2021. Patients were retrospectively divided into the fall and non-fall groups, and the groups were compared for medication usage. The fall and non-fall groups included 132 and 6857 patients respectively. A significantly higher proportion of patients in the fall group used hypnotics (40.2% vs. 21.7%; p < 0.0001). Hypnotics remained significantly associated with a higher risk of falls after adjusting for confounders (adjusted odds ratio [OR] = 1.67, 95% confidence interval [CI] = 1.13-2.48, p = 0.01). In particular, the use of benzodiazepines was associated with a significantly higher risk of falls (adjusted OR = 2.08, 95% CI = 1.38-3.15, p = 0.0005). Meanwhile, suvorexant use was not linked to the risk of falls, and lemborexant use was associated with a significantly lower risk of falls (adjusted OR = 0.27, 95% CI = 0.09-0.84, p = 0.02). The use of hypnotics is a risk factor for falls, but orexin receptor antagonists may represent a safe option for patients requiring hypnotics. Our results provide evidence supporting the safety of these drugs. © 2022 John Wiley & Sons Ltd.

Citation

Rintaro Sogawa, Akiko Emoto, Akira Monji, Yuki Miyamoto, Misako Yukawa, Toru Murakawa-Hirachi, Yasuhiro Tagomori, Mikiko Kawasaki, Shinya Kimura, Chisato Shimanoe. Association of orexin receptor antagonists with falls during hospitalization. Journal of clinical pharmacy and therapeutics. 2022 Jun;47(6):809-813