Association between Elimination Half-life of Benzodiazepines and Falls in the Elderly: A Meta-analysis of Observational Studies

Masudo Chikako, Ogawa Yukari, Yamashita Naomi, Mihara Kiyoshi

doi:10.1248/yakushi.18-00156

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高齢者におけるベンゾジアゼピン受容体作動薬の半減期と転倒との関連性：観察研究のメタアナリシス
コウレイシャニオケルベンゾジアゼピンウケヨウダイサドウヤクノハンゲンキトテントウトノカンレンセイ : カンサツケンキュウノメタアナリシス

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<p>Benzodiazepine receptor agonists (BZDRAs) have been associated with an increased risk of falls in the elderly. However, the association between the elimination half-life (t_1/2) of BZDRAs and the difference between benzodiazepines (BZDs) and non-benzodiazepines (Z-drugs) has not been clarified. By conducting a meta-analysis of observational studies, we compared the risk of falls with respect to 1) short-acting BZDRAs (t_1/2<12 h) vs. long-acting BZDRAs (t_1/2≥12 h) and 2) BZDs vs. Z-drugs in elderly patients. Data were retrieved from MEDLINE, the Cochrane Library, and Igaku Chuo Zasshi. In total, 13 observational studies from 12 articles were included in our study (short-acting BZDRAs, n=12; long-acting BZDRAs, n=9; BZDs, n=13; Z-drugs, n=7). The risk of falls was significantly increased by the use of short-acting BZDRAs [Odds ratio (OR) (95% Confidence interval (CI)): 2.00 (1.46-2.73)], long-acting BZDRAs [OR (95%CI): 2.16 (1.61-2.89)], BZDs [OR (95%CI): 1.67 (1.31-2.13)], and Z-drugs [OR (95%CI): 2.42 (1.35-4.34)] compared to the risk in BZDRAs non-users. The increased risk of falls in elderly patients was similar in each group and unrelated to t_1/2. This study suggested that all BZDRAs including Z-drugs should be avoided in elderly patients.</p>

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YAKUGAKU ZASSHI

YAKUGAKU ZASSHI 139 (1), 113-122, 2019-01-01

The Pharmaceutical Society of Japan

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