title: Multi-country rapid adverse drug event assessment: the Asian Pharmacoepidemiology Network (AsPEN) antipsychotic and acute hyperglycaemia study.
abstract: OBJECTIVE
  To undertake a multi-country study to investigate the risk of acute hyperglycaemia with antipsychotic use.
  
  
  METHODS
  Using a distributed network model with a common minimal data set, we performed a prescription sequence symmetry analysis (PSSA) to investigate the risk of acute hyperglycaemia associated with antipsychotic initiation. Incident insulin prescriptions were used as a proxy indicator of acute hyperglycaemia. Participating countries and population datasets included Australia (300,000 persons), Japan I (300,000 persons), Japan II (200,000 persons), Korea (53 million persons) Taiwan (1 million persons), Sweden (9 million persons), USA-Public (87 million persons) and USA-Private (47 million persons).
  
  
  RESULTS
  Olanzapine showed a trend towards increased risk in most databases, with a significant association observed in the USA-Public database (Adjusted sequence ratio (ASR) = 1.14; 95% Confidence Interval (CI) 1.10-1.17) and Sweden (ASR = 1.53; 95% CI 1.13-2.06). Null or negative associations were observed for haloperidol, quetiapine and risperidone.
  
  
  CONCLUSIONS
  Acute hyperglycaemia appears to be associated with olanzapine use, however, this effect was only observed in two large databases. Despite different patterns of utilization of both antipsychotics and insulin, PSSA analysis results for individual antipsychotic medicines were qualitatively similar across most countries. PSSA, used in conjunction with existing methods, may provide a simple and timely method further supporting multi-national drug safety monitoring.
authors.affiliation: Quality Use of Medicines and Pharmacy Research Centre, Sansom Institute for Health Research, University of South Australia, Adelaide, Australia.
authors.forename: Nicole
authors.initials: N
authors.lastname: Pratt
authors.forename: Morten
authors.initials: M
authors.lastname: Andersen
authors.forename: Ulf
authors.initials: U
authors.lastname: Bergman
authors.forename: Nam-Kyong
authors.initials: NK
authors.lastname: Choi
authors.forename: Tobias
authors.initials: T
authors.lastname: Gerhard
authors.forename: Cecilia
authors.initials: C
authors.lastname: Huang
authors.forename: Michio
authors.initials: M
authors.lastname: Kimura
authors.forename: Tomomi
authors.initials: T
authors.lastname: Kimura
authors.forename: Kiyoshi
authors.initials: K
authors.lastname: Kubota
authors.forename: Edward Chia-Cheng
authors.initials: EC
authors.lastname: Lai
authors.forename: Nobuhiro
authors.initials: N
authors.lastname: Ooba
authors.forename: Urban
authors.initials: U
authors.lastname: Osby
authors.forename: Byung-Joo
authors.initials: BJ
authors.lastname: Park
authors.forename: Tsugumichi
authors.initials: T
authors.lastname: Sato
authors.forename: Ju-Young
authors.initials: JY
authors.lastname: Shin
authors.forename: Anders
authors.initials: A
authors.lastname: Sundström
authors.forename: Yea-Huei Kao
authors.initials: YH
authors.lastname: Yang
authors.forename: Elizabeth E
authors.initials: EE
authors.lastname: Roughead
mesh_terms: D016907:Adverse Drug Reaction Reporting Systems; D014150:Antipsychotic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D001315:Australia / Q000453:epidemiology; D011307:Drug Prescriptions / Q000706:statistics & numerical data; D005202:Asia, Eastern / Q000453:epidemiology; D006801:Humans; D006943:Hyperglycemia / Q000139:chemically induced* / Q000453:epidemiology*; D016571:Neural Networks, Computer; D017891:Pharmacoepidemiology; D013548:Sweden / Q000453:epidemiology; D014481:United States / Q000453:epidemiology
chemical_list: D014150:Antipsychotic Agents
keywords: Asian Pharmacoepidemiology Network (AsPEN); antipsychotics; distributed network model; hyperglycaemial; multi-national collaboration; pharmacoepidemiology; prescription sequence symmetry analysis