Prescribing in autism: trends, inequalities, and outcomes (360G-Wellcome-317441_Z_24_Z)

Aims 1A: Describe time trends in psychotropic and lipid-lowering medication prescribing in autistic adults. 1B: Assess whether adverse medication effects are more likely to be recorded for autistic adults, compared with non-autistic adults. 2: Quantify possible drug-gene interactions in an autism cohort. 3: Characterise the overlap between autism and cardiovascular risk factors and outcomes. Methods 1A&B: In population-based British and Swedish data, I will compare psychotropic and lipid-lowering medication prescribing trends in autistic adults against non-autistic adults. I will then examine cardiometabolic outcomes in autistic adults prescribed these medications compared to groups stratified by autism and prescribing status. I will triangulate results from complementary study designs to determine the strength of evidence for i) psychotropic prescribing causing adverse cardiometabolic outcomes in autism and for ii) cardiometabolic conditions being undertreated in autism. 2: I will quantify the presence of clinically relevant pharmacogenomic alleles in two genotyped autistic cohorts and identify the proportion of individuals that have been prescribed medications for which international pharmacogenomic guidelines recommend treatment modifications. 3: I will use complementary approaches on genome-wide summary statistics to identify genetic variants, genes, and biological pathways that may contribute to the association of cardiometabolic outcomes with autism.