SHM Converge Scientific Abstract ePoster Gallery-Risk of Encephalopathy and Mortality Associated With Baclofen: A Real-World Cohort Study

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This real-world, new-user, active-comparator cohort study examined adults treated in a Geisinger Health system between 2005 and 2018 to compare baclofen with cyclobenzaprine. Using propensity score inverse probability of treatment weighting to balance 45 demographic, comorbidity, and coprescription factors, the researchers estimated risks of encephalopathy and mortality after starting baclofen versus cyclobenzaprine.<br /><br />Among 9,366 new baclofen users and 50,236 new cyclobenzaprine users, baclofen was associated with a consistently higher risk of encephalopathy. The adjusted hazard ratio was 2.35 at 30 days, 2.06 at 90 days, 2.02 at 180 days, and 1.94 at 1 year. Absolute event rates were also higher for baclofen at each time point. The increased encephalopathy risk persisted throughout the first year and was not meaningfully modified by age or estimated glomerular filtration rate.<br /><br />Baclofen was also linked to higher mortality. The adjusted hazard ratio for death was 1.85 at 30 days, 1.59 at 90 days, 1.57 at 180 days, and 1.42 at 1 year compared with cyclobenzaprine.<br /><br />In summary, baclofen use was associated with greater risks of both encephalopathy and mortality than cyclobenzaprine in routine clinical care. These findings suggest that prescribers should carefully weigh the benefits and harms of baclofen when considering systemic muscle relaxants, especially given its known central nervous system depressant effects.

Asset Subtitle

Yoseob Joseph Hwang

Meta Tag

Author List Alex R. Chang, Daniel J. Brotman, Jung-Im Shin, Lesley A. Inker, Morgan E. Grams, Yoseob Joseph Hwang

Category Research

Concept Cohort Study

Concept Encephalopathy

Concept Mortality

Concept Baclofen

Concept Cyclobenzaprine

Distinguished Non-Finalist

Presenter Organization Johns Hopkins University

Presenting Author Yoseob Joseph Hwang

Track Outcomes Research

Keywords

baclofen

cyclobenzaprine

encephalopathy

mortality

cohort study

propensity score weighting

muscle relaxants

real-world evidence

hazard ratio

Geisinger Health system

Cohort Study

Encephalopathy

Mortality

Baclofen

Cyclobenzaprine