Table 3 Prevalence ratios for 37 medication class triads (each composed of first, second, and third medication classes below) enriched in the subset of adults with multimorbidity in 22q11.2DS (median age 38.6 years) compared with the general population (median age 62 years)

From: A genetic model for multimorbidity in young adults

First medication class	ATC code	Second medication class	ATC code	Third medication class	ATC code	Prevalence ratio (95% CI)^b,c,d
Antiepileptics	N03A	Antipsychotics	N05A	Antidepressants	N06A	9.0^a (4.4–18.7)
Thyroid preparations	H03A	Antiepileptics	N03A	Antipsychotics	N05A	6.9^a (3.2–14.8)
Thyroid preparations	H03A	Antipsychotics	N05A	Antidepressants	N06A	5.2^a (2.3–11.7)
Vitamin A and D, including combinations of the two	A11C	Thyroid preparations	H03A	Antipsychotics	N05A	5.2^a (2.3–11.7)
Vitamin A and D, including combinations of the two	A11C	Antiepileptics	N03A	Antipsychotics	N05A	4.7^a (2.1–10.9)
Thyroid preparations	H03A	Antiepileptics	N03A	Antidepressants	N06A	3.9^a (1.6–9.3)
Vitamin A and D, including combinations of the two	A11C	Antiepileptics	N05A	Antidepressants	N06A	3.9^a (1.6–9.3)
Vitamin A and D, including combinations of the two	A11C	Antipsychotics	N03A	Antidepressants	N06A	3.9^a (1.6–9.3)
Vitamin A and D, including combinations of the two	A11C	Thyroid preparations	H03A	Antidepressants	N06A	3.5^a (1.4–8.6)
Vitamin A and D, including combinations of the two	A11C	Thyroid preparations	H03A	Antiepileptics	N03A	3.5^a (1.4–8.6)
Anticholinergic agents	N04A	Antipsychotics	N05A	Antidepressants	N06A	2.6 (0.96–7.0)
Antiepileptics	N03A	Anticholinergic agents	N04A	Antipsychotics	N05A	2.6 (0.96–7.0)
Beta blocking agents	C07A	Antiepileptics	N03A	Antidepressants	N06A	2.6 (0.96–7.0)
Lipid modifying agents, plain	C10A	Antipsychotics	N05A	Antidepressants	N06A	2.2 (0.8–6.2)
Beta blocking agents	C07A	Antiepileptics	N03A	Antipsychotics	N05A	2.2 (0.8–6.2)
Antipsychotics	N05A	Anxiolytics	N05B	Antidepressants	N06A	2.2 (0.8–6.2)
Antiepileptics	N03A	Antipsychotics	N05A	Other drugs used for obstructive airway diseases, inhalants	R03B	2.2 (0.8–6.2)
Drugs for peptic ulcer and gastroesophageal reflux disease (GORD)^f	A02B	Antipsychotics	N05A	Antidepressants	N06A	2.2 (0.8–6.2)
Antiepileptics	N03A	Anxiolytics	N05B	Antidepressants	N06A	1.7 (0.5–5.4)
Antiepileptics	N03A	Antipsychotics	N05A	Adrenergics, inhalants	R03A	1.7 (0.5–5.4)
Antiepileptics	N03A	Antipsychotics	N05A	Anxiolytics	N05B	1.7 (0.5–5.4)
Antiepileptics	N03A	Anticholinergic agents	N04A	Antidepressants	N06A	1.7 (0.5–5.4)
Thyroid preparations	H03A	Antipsychotics	N05A	Other drugs used for obstructive airway diseases, inhalants	R03B	1.7 (0.5–5.4)
Thyroid preparations	H03A	Antipsychotics	N05A	Adrenergics, inhalants	R03A	1.7 (0.5–5.4)
Hormonal contraceptives for systemic use	G03A	Antiepileptics	N03A	Antidepressants	N06A	1.7 (0.5–5.4)
Hormonal contraceptives for systemic use	G03A	Antiepileptics	N03A	Antipsychotics	N05A	1.7 (0.5–5.4)
Lipid modifying agents, plain	C10A	Antiepileptics	N03A	Antidepressants	N06A	1.7 (0.5–5.4)
Beta blocking agents	C07A	Antipsychotics	N05A	Antidepressants	N06A	1.7 (0.5–5.4)
Beta blocking agents	C07A	Anticholinergic agents	N04A	Antipsychotics	N05A	1.7 (0.5–5.4)
Beta blocking agents	C07A	Thyroid preparations	H03A	Antipsychotics	N05A	1.7 (0.5–5.4)
Antithrombotic agents	B01A	Antiepileptics	N03A	Antipsychotics	N05A	1.7 (0.5–5.4)
Vitamin A and D, including combinations of the two	A11C	Beta blocking agents	C07A	Thyroid preparations	H03A	1.7 (0.5–5.4)
Blood glucose lowering drugs, excluding insulins	A10B	Antiepileptics	N03A	Antidepressants	N06A	1.7 (0.5–5.4)
Blood glucose lowering drugs, excluding insulins	A10B	Antiepileptics	N03A	Antipsychotics	N05A	1.7 (0.5–5.4)
Blood glucose lowering drugs, excluding insulins	A10B	Beta blocking agents	C07A	Antiepileptics	N03A	1.7 (0.5–5.4)
Drugs for constipation	A06A	Antipsychotics	N05A	Antidepressants	N06A	1.7 (0.5–5.4)
Drugs for peptic ulcer and gastroesophageal reflux disease (GORD)^e	A02B	Corticosteroids, plain^f	D07A	Antidepressants	N06A	1.7 (0.5–5.4)

ATC Anatomical Therapeutic Chemical Classification System, CI confidence interval.
^aSignificant difference between groups (prevalence ratio and 95% confidence interval calculations; see “Materials and Methods” and Supplemental Methods for details).
^bPrevalence ratios were calculated based on medication use within the group with multimorbidity at any age (see “Materials and Methods” for details).
^cOnly triads at 3% or greater were reported for Canadian population data. Therefore, to calculate the prevalence ratio and estimate the 95% confidence limits for population data, we assigned a 3.1% value (the lowest reportable prevalence) and a standard error of 1%. For more details, see Supplemental Methods and Table S4 for triads enriched in the population vs the 22q11.2DS group. This includes where prevalence equals 0 for the 22q11.2DS population, and thus for the upper 95% confidence limit we used the approximation 3/N.⁴⁰
^dComparisons for three ATC classes (Other Analgesics and Antipyretics [N02B], Anti-inflammatory…, Non-Steroids [M01A], Calcium [A12A]) were not performed as medications in these classes are commonly available over the counter and thus were excluded from the 22q11.2DS sample.
^ePrevalences for these drug classes are likely underestimated for the 22q11.2DS group, since any medications that could have been either over the counter and/or noted to be used “as needed” were excluded.
^fPrevalence may be overestimated for the 22q11.2DS population, since medications that could have been available over the counter in this class were assumed to be prescription.

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Table 3 Prevalence ratios for 37 medication class triads (each composed of first, second, and third medication classes below) enriched in the subset of adults with multimorbidity in 22q11.2DS (median age 38.6 years) compared with the general population (median age 62 years)

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