As baclofen has been associated with encephalopathy in patients with chronic kidney disease (CKD), Canadian researchers have recently conducted a retrospective cohort study comparing the 30-day incidence risk between patients taking ≥ 20 mg baclofen per day and those taking <20 mg per day. In addition, encephalopathy risk was compared between baclofen users and non-users. The study included 15,942 patients aged 66 years and older (median age 77 years) with CKD, 61% of whom started baclofen at ≥ 20 mg/day and 39% at <20 mg/day. Hospitalisation with encephalopathy was more prevalent in patients starting with ≥20 mg/day (1.11%) than in patients starting with <20 mg/day (0.42%). When compared to 284,263 non-users, a higher risk of encephalopathy was observed for both baclofen treatment groups, with the <20 mg/day weighted risk ratio (RR): 5.90 [95% CI, 3.59 to 9.70] and the ≥20 mg/day weighted RR: 19.8 [95% CI, 14.0 to 28.0]). The study, which can be viewed here, confirms an increased risk of encephalopathy associated with baclofen use in patients with CKD, especially at higher doses.

Contributed by Australian Medication Safety Services Associate – Isabella Singh