Abstract：
Pharmacoepidemiologic studies using routinely collected data allow researchers to propose drugs for repurposing trials for dementia prevention or treatment. A recent cohort study reported a 54% lower dementia risk among users of sildenafil compared to users of certain cardiovascular medications. We caution that \"confounding by indication\" can arise when outcomes are compared between a drug of interest and an inappropriate comparator. Here, we emphasize important considerations in selecting an active comparator. We assess the implications of substantial risk of confounding by indication in pharmacoepidemiologic studies linking phosphodiesterase-5 inhibitors to lower dementia risk.
摘要：
使用常规收集的数据进行的药物流行病学研究使研究人员能够提出用于痴呆预防或治疗的再利用试验的药物。最近的一项队列研究报告说，与某些心血管药物的使用者相比，西地那非使用者的痴呆风险降低了54％。我们警告说，当在感兴趣的药物和不适当的比较器之间比较结果时，可能会出现“指示混淆”。这里,我们强调在选择主动比较器时的重要考虑因素。我们在药物流行病学研究中将磷酸二酯酶-5抑制剂与降低痴呆风险联系起来，评估了大量混杂风险的含义。
