FDA adverse event reporting system

FDA 不良事件报告系统
  • 文章类型: Journal Article
    本研究旨在根据现实世界的数据评估伏立康唑(VRC)与中枢神经系统(CNS)毒性之间的关系。
    FAERS2004年1月至2022年3月的报告纳入了我们的研究。中枢神经系统毒性事件是通过使用调节活动术语医学词典来鉴定的。使用对应于95%置信区间的报告比值比来量化VRC相关CNS事件的信号。
    精神疾病的总体ROR(95CI),神经系统疾病和眼部疾病为1.84(1.70,2.00),1.09(1.01、1.18)和3.84(3.48、4.23),分别为(p<0.05)。VRCCNS事件的中位时间为1(IQR0-5)天。前六个信号是黄斑混浊,绿麻,闪烁暗点,中毒性视神经病变,角膜出血和色泽异常,所有这些都被归类为眼部疾病。与伊曲康唑相比,氟康唑,泊沙康唑和伊沙康康唑,VRC显示出显著的相关性和较高的精神病发病率,神经系统疾病和眼部疾病,分别为(p<0.05)。
    VRC与CNS毒性显著相关。剂量调整,基于模型的个体化治疗方案和治疗药物监测指导的个体化用药方案可能是提高VRC疗效和减少不良事件的良好策略。
    UNASSIGNED: This study aims to evaluate the relationship between voriconazole (VRC) and central nervous system (CNS) toxicity based on the real world data.
    UNASSIGNED: The reports of FAERS from January 2004 to March 2022 were included in our study. The CNS toxicity events were identified by using Medical Dictionary for Regulatory Activities terms. Reporting odds ratios corresponding 95% confidence intervals were employed to quantify the signals of VRC-associated CNS events.
    UNASSIGNED: The overall RORs (95%CI) for psychiatric disorders, nervous system disorders and eye disorders were 1.84 (1.70, 2.00), 1.09 (1.01, 1.18) and 3.84 (3.48, 4.23), respectively (p<0.05). The median time to the CNS events of VRC was 1(IQR 0-5) day. Top six signals were macular opacity, chloropsia, scintillating scotoma, toxic optic neuropathy, corneal bleeding and dyschromatopsia, all of them grouped as eye disorders. Compared with itraconazole, fluconazole, posaconazole and isavuconazole, VRC shows significantly relationship and higher incidence rate of psychiatric disorders, nervous system disorders and eye disorders, respectively (p<0.05).
    UNASSIGNED: VRC was significantly association with the CNS toxicity. Dosing adjustment, model based individualized treatment project and the therapeutic drug monitoring guided individualized medication regime could be the good strategies for the efficacy improving and the adverse events reducing of VRC.
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  • 文章类型: Journal Article
    舒尼替尼被批准用于治疗转移性肾细胞癌(mRCC),伊马替尼耐药胃肠道间质瘤(GIST),和晚期胰腺神经内分泌肿瘤(PNET)。本研究旨在通过美国食品和药物管理局不良事件报告系统(FAERS)的数据挖掘来调查舒尼替尼的安全性。
    2006年第一季度至2024年第一季度舒尼替尼的个例安全性报告(ICSR)是从食品和药物管理局不良事件报告系统(FAERS)的ASCII数据包中收集的。标准化数据后,各种不相称性分析,包括报告赔率比(ROR),比例报告比率(PRR),贝叶斯置信度传播神经网络(BCPNN),多项目伽玛泊松收缩仪(MGPS)用于识别舒尼替尼相关AE的潜在安全性信号.
    在报告期内,共有35,923种ICSR的舒尼替尼被确定为“主要可疑”药物。搜索检测到276个不成比例的首选术语(PT)。最常见的AE,包括腹泻,虚弱,食欲下降,高血压,和味觉障碍,与药物标签和临床试验一致。意外重大AE,如葡萄膜黑色素细胞增生,唾液腺瘘,黄皮肤,睫毛变色,阴囊炎症,被检测到。舒尼替尼相关不良事件的中位发病时间为57天(四分位距[IQR]16-170天),大多数ICSR在开始舒尼替尼治疗后的第一个月内发展(n=4,582,39.73%)。
    我们的研究结果与常规临床观察结果一致,舒尼替尼也发现了一些意外的AE信号,为舒尼替尼在现实世界中的安全使用提供有价值的证据,并有助于舒尼替尼的临床监测和风险识别。
    UNASSIGNED: Sunitinib is approved for the treatment of metastatic renal cell carcinoma (mRCC), imatinib-resistant gastrointestinal stromal tumors (GIST), and advanced pancreatic neuroendocrine tumors (PNET). This study aims to investigate the safety profiles of sunitinib through data mining of the US Food and Drug Administration Adverse Event Reporting System (FAERS).
    UNASSIGNED: The individual case safety reports (ICSRs) on sunitinib from 2006 Q1 to 2024 Q1 were collected from the ASCII data packages in the Food and Drug Administration Adverse Event Reporting System (FAERS). After standardizing the data, a variety of disproportionality analyses, including the reporting odds ratio (ROR), the proportional reporting ratio (PRR), the bayesian confidence propagation neural network (BCPNN), and the multi-item gamma Poisson shrinker (MGPS) were employed to identify the potential safety signals of sunitinib-associated AEs.
    UNASSIGNED: A total of 35,923 ICSRs of sunitinib as the \"primary suspected\" drug were identified within the reporting period. The search detected 276 disproportionate preferred terms (PTs). The most common AEs, including diarrhea, asthenia, decreased appetite, hypertension, and dysgeusia, were consistent with the drug label and clinical trials. Unexpected significant AEs, such as uveal melanocytic proliferation, salivary gland fistula, yellow skin, eyelash discoloration, scrotal inflammation, were detected. The median onset time of sunitinib-related AEs was 57 days (interquartile range [IQR]16-170 days), with most of the ICSRs developing within the first month (n = 4,582, 39.73%) after sunitinib therapy as initiated.
    UNASSIGNED: The results of our study were consistent with routine clinical observations, and some unexpected AEs signals were also identified for sunitinib, providing valuable evidence for the safe use of sunitinib in the real-world and contributing to the clinical monitoring and risk identification of sunitinib.
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  • 文章类型: Journal Article
    FDA不良事件报告系统(FAERS)用于挖掘和评估与细胞周期蛋白依赖性激酶(CDK)4/6抑制剂相关的不良事件(AE)。从而为临床合理用药提供参考。
    从FAERS获取了2015年第一季度至2023年第一季度与CDK4/6抑制剂相关的AE数据,同时使用报告比值比(ROR)方法和贝叶斯置信度传播神经网络(BCPNN)方法处理信号挖掘。
    CDK4/6抑制剂的AE报告数量分别为132,494对于palbociclib56,151对于ribociclib,和7,014为abemaciclib。AE信号的相应数量为319、517和59,涉及的系统器官类别(SOC)的数量为23、23和15,主要涉及血液和淋巴系统疾病,呼吸,胸部和纵隔疾病,肝胆疾病,皮肤和皮下组织疾病,等。
    CDK4/6抑制剂可导致肺毒性,骨髓抑制,皮肤反应,等。应特别注意abemaciclib治疗间质性肺病(ILD),多形性红斑,和血栓形成风险;瑞博西尼用于心脏毒性,肝毒性,和肌肉骨骼毒性;palbociclib治疗神经认知障碍和颌骨坏死。
    UNASSIGNED: The FDA Adverse Event Reporting System (FAERS) was used to mine and evaluate adverse events (AEs) associated with cyclin-dependent kinase (CDK) 4/6 inhibitors, thereby providing a reference for clinical rational drug use.
    UNASSIGNED: AE data related to CDK4/6 inhibitors from the first quarter of 2015 to the first quarter of 2023 were acquired from FAERS, while the signal mining was processed using the reporting odds ratio (ROR) method and Bayesian confidence propagation neural network (BCPNN) method.
    UNASSIGNED: The number of AE reports for CDK4/6 inhibitors was, respectively, 132,494 for palbociclib, 56,151 for ribociclib, and 7,014 for abemaciclib. The corresponding numbers of AE signals were 319, 517, and 59, with the number of involved System Organ Class (SOC) being 23, 23, and 15, mainly involving blood and lymphatic system disorders, respiratory, thoracic and mediastinal disorders, hepatobiliary disorders, skin and subcutaneous tissue disorders, etc.
    UNASSIGNED: CDK4/6 inhibitors could lead to pulmonary toxicity, myelosuppression, skin reactions, etc. Special attention should be paid to abemaciclib for interstitial lung disease (ILD), erythema multiforme, and thrombosis risk; ribociclib for cardiac toxicity, hepatotoxicity, and musculoskeletal toxicity; palbociclib for neurocognitive impairment and osteonecrosis of the jaw.
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  • 文章类型: Journal Article
    白细胞介素-6(IL-6)单克隆抗体因其在治疗2019年冠状病毒病(COVID-19)中的功效而被公认;然而,关于其潜在不利影响的综合研究仍然很少。
    这是一项回顾性药物警戒调查。我们采用了使用OpenVigilFDA的FAERS来检测与白介素-6拮抗剂托珠单抗和sarilumab相关的不良反应。
    从FAERS数据库中收集了完整的17,037,364份报告,有67,976份报告被确定为托珠单抗的“主要可疑(PS)”不良事件(AE),和12,560份sarilumab报告。两种药物诱导的AE涉及27个器官系统。在所有四种算法中,同时保留了符合sarilumab标准的109个显著不相称性首选项(PT)和158个显著不相称性PT。45-64岁女性不良反应发生率较高,后续住院率较高。两种药物均表现出与先前报道的副作用一致的不良反应。比如白细胞减少症,肝酶升高,和高胆固醇血症.此外,与胃肠道问题有很强的相关性.意外的重大不良事件,包括糖尿病,血压波动,药物无效,恶性肿瘤,和神经系统的紊乱,也被观察到了。与IL-6RAs相关的AE信号存在性别和年龄差异。
    我们的研究确定了白细胞介素6受体拮抗剂的重要新的AE信号,潜在支持此类药物的临床监测和风险识别。
    UNASSIGNED: Interleukin-6 (IL-6) monoclonal antibodies are commonly acknowledged for their efficacy in managing coronavirus disease 2019 (COVID-19); however, there remains a paucity of comprehensive studies on their potential adverse effects.
    UNASSIGNED: This is a retrospective pharmacovigilance investigation. We employed FAERS using OpenVigil FDA to detect adverse reactions linked to the interleukin-6 antagonist tocilizumab and sarilumab.
    UNASSIGNED: Completely 17,037,364 reports were collected from the FAERS database, with 67,976 reports identified as \'primary suspected (PS)\' adverse events (AEs) for tocilizumab, and 12,560 reports for sarilumab. AEs induced by both drugs involved 27 organ systems. 109 significant disproportionality preferred terms (PTs) of tocilizumab and 158 significant disproportionality PTs meeting the criteria of sarilumab across all four algorithms were retained simultaneously. A higher incidence of adverse reactions occurred in females aged 45-64 years, with a higher rate of subsequent hospitalization. Both drugs exhibited adverse reactions consistent with previously reported side effects, such as leukopenia, elevated liver enzymes, and hypercholesterolemia. Additionally, there was a strong correlation with gastrointestinal issues. Unexpected significant adverse events, including diabetes, fluctuations in blood pressure, drug ineffectiveness, malignancies, and disorders of the nervous system, were also observed. Gender and age differences existed in AEs signals related to IL-6RAs.
    UNASSIGNED: Our study identified significant new AE signals for interleukin-6 receptor antagonists, potentially supporting clinical monitoring and risk identification for this class of drugs.
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  • 文章类型: Journal Article
    使用来自FDA的FAERS数据库的数据分析了与右美托咪定相关的不良事件,从2004年到2023年第三季度。该分析为监测右美托咪定在临床应用中的安全性奠定了基础。
    对与右美托咪定相关的不良事件数据进行标准化和分析,以确定与其使用密切相关的临床不良事件。该分析采用了各种信号量化分析算法,包括报告赔率比(ROR),比例报告比率(PRR),贝叶斯置信传播神经网络(BCPNN),和多项目伽玛泊松收缩器(MGPS)。
    在FAERS数据库中,右美托咪定被确定为1,910例不良事件的主要嫌疑人.我们的分析涵盖了26个器官系统水平,我们从中选择了346个相关的首选术语(PT)进行进一步检查。值得注意的是,药物不良反应,如尿崩症,异常经颅电机诱发电位监测,急性运动性轴索神经病,和三叉神经心脏反射被确定。这些反应在药物说明书中没有明确提到,表明药物不良反应新信号的出现。
    FAERS数据库中的数据挖掘阐明了右美托咪定相关药物不良反应的特征。该分析增强了我们对右美托咪定药物安全性的理解,有助于药物警戒研究的临床管理,并为完善药物使用协议提供了有价值的见解。
    UNASSIGNED: Adverse events associated with dexmedetomidine were analyzed using data from the FDA\'s FAERS database, spanning from 2004 to the third quarter of 2023. This analysis serves as a foundation for monitoring dexmedetomidine\'s safety in clinical applications.
    UNASSIGNED: Data on adverse events associated with dexmedetomidine were standardized and analyzed to identify clinical adverse events closely linked to its use. This analysis employed various signal quantification analysis algorithms, including Reporting Odds Ratio (ROR), Proportional Reporting Ratio (PRR), Bayesian Confidence Propagation Neural Network (BCPNN), and Multi-Item Gamma Poisson Shrinker (MGPS).
    UNASSIGNED: In the FAERS database, dexmedetomidine was identified as the primary suspect in 1,910 adverse events. Our analysis encompassed 26 organ system levels, from which we selected 346 relevant Preferred Terms (PTs) for further examination. Notably, adverse drug reactions such as diabetes insipidus, abnormal transcranial electrical motor evoked potential monitoring, acute motor axonal neuropathy, and trigeminal cardiac reflex were identified. These reactions are not explicitly mentioned in the drug\'s specification, indicating the emergence of new signals for adverse drug reactions.
    UNASSIGNED: Data mining in the FAERS database has elucidated the characteristics of dexmedetomidine-related adverse drug reactions. This analysis enhances our understanding of dexmedetomidine\'s drug safety, aids in the clinical management of pharmacovigilance studies, and offers valuable insights for refining drug-use protocols.
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  • 文章类型: Journal Article
    关于PARP抑制剂(PARPis)相关的急性肾衰竭(ARF)的当前临床试验数据并不完全代表现实世界的情况。因此,在这项研究中,美国食品和药物管理局不良事件报告系统(FAERS)用于评估PARPis相关的ARF。
    数据是从2015年1月1日至2023年9月30日获得的。基于四种算法分析ARF事件报告。评估PARPis相关ARF的发病时间(TTO)和临床结局。
    纳入病例总数为2726例。观察到奥拉帕尼的显著信号,尼拉帕利,和rucaparib(报告优势比(ROR):1.62,95%置信区间(CI):1.49-1.781.25,95%CI:1.19-1.32和1.59,95%CI:1.47-1.72),所有这些都有“血肌酐升高”和“肾小球滤过率降低”的阳性信号。奥拉帕尼的ARF发作的中位TTO为57、36和85天,尼拉帕利,和rucaparib,分别。死亡的比例,危及生命的事件,与ARF相关的住院不良事件(AE)为4.27%,3.57%,19.80%,分别。奥拉帕尼死亡比例(9.88%)显著高于尼拉帕尼(2.52%)和鲁卡帕尼(2.94%)(p<0.005)。与尼拉帕尼相关的危及生命的AE的比例(4.89%)显着高于rucaparib(0.98%)(p<0.005)。
    ARF和PARPi相关,除了talazoparib.肌酐水平升高和肾小球滤过率下降与奥拉帕尼有关,尼拉帕利,还有rucaparib.由于严重不良事件和延迟不良反应的比例较高,因此应更加重视PARPis相关的ARF。
    UNASSIGNED: Current clinical trial data on PARP inhibitors (PARPis)-related acute renal failure (ARF) are not entirely representative of real-world situations. Therefore, in this study, the US Food and Drug Administration Adverse Event Reporting System (FAERS) was used to evaluate PARPis-related ARF.
    UNASSIGNED: Data were obtained from 1 January 2015, to 30 September 2023. ARF event reports were analyzed based on four algorithms. The time-to-onset (TTO) and clinical outcomes of PARPis-associated ARF were assessed.
    UNASSIGNED: The total included cases were 2726. Significant signals were observed for olaparib, niraparib, and rucaparib (reporting odds ratio (ROR): 1.62, 95% confidence interval (CI): 1.49-1.78, 1.25, 95% CI: 1.19-1.32 and 1.59, 95% CI: 1.47-1.72 respectively). The median TTO of ARF onset was 57, 36, and 85 days for olaparib, niraparib, and rucaparib, respectively. The proportion of deaths with olaparib (9.88%) was significantly higher than for niraparib (2.52%) and rucaparib (2.94%) (p < 0.005). The proportion of life-threatening adverse events associated with niraparib (4.89%) was significantly higher than for rucaparib (0.98%) (p < 0.005).
    UNASSIGNED: ARF and PARPi were related, with the exception of talazoparib. More emphasis should be given to PARPis-related ARF due to the high proportion of serious AEs and delayed adverse reactions.
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  • 文章类型: Journal Article
    使用FAERS数据库中的数据全面分析与Denosumab(Prolia)治疗骨质疏松症相关的ADR,并更好地了解Denosumab(Prolia)治疗的潜在风险和副作用。
    Denosumab(Prolia)的数据是从FAERS数据库收集的,涵盖了2010年第一季度至2023年第三季度的时期。不相称性分析是通过计算报告优势比(ROR),比例报告比率(PRR),和贝叶斯分析置信度传播神经网络(BCPNN)来检测正信号。
    完全,从FAERS数据库收集了17,985,365份报告,1,97,807份Denosumab(Prolia)报告被确定为“主要可疑(PS)”ADR。Denosumab(Prolia)诱导的ADR发生在27个器官系统中。同时保留了38个满足三种算法的显著不成比例PT。也会发生意外的显着ADR,例如骨密度异常和不动。大多数ADR发生在Denosumab(Prolia)开始后的前30天内。
    基于美国FAERS数据库,Denosumab(Prolia)的高频ADR是低钙血症,骨密度异常,湿疹,回弹效应,脊柱畸形,等。本药的临床应用应集中于这部分ADR。还应注意新发现的ADR,比如不动的,更年期症状,等。,避免更严重的后果。队列研究,更详细和全面的案例信息,需要进行长期的临床研究来确认这些结果,并进一步了解Denosumab(Prolia)的安全性.
    UNASSIGNED: To comprehensively analyze the ADRs associated with Denosumab (Prolia) in the treatment of osteoporosis using data from the FAERS database, and gain a better understanding of the potential risks and side effects of Denosumab (Prolia) therapy.
    UNASSIGNED: Data of Denosumab (Prolia) were collected from the FAERS database covering the period from first quarter of 2010 to the third quarter of 2023. Disproportionality analysis was performed by calculating the reporting odds ratios (ROR), proportional reporting ratio (PRR), and Bayesian analysis confidence propagation neural network (BCPNN) to detect positive signals.
    UNASSIGNED: Totally, 17,985,365 reports were collected from the FAERS database, 1,97,807 reports of Denosumab (Prolia) were identified as the \"primary suspected (PS)\" ADRs. Denosumab (Prolia) induced ADRs occurred in 27 organ systems. 38 significant disproportionality PTs satisfying with the three algorithms were retained at the same time. Unexpected significant ADRs such as bone density abnormal and immobile also occur. The majority of the ADRs occurred within the first 30 days after Denosumab (Prolia) initiation.
    UNASSIGNED: Based on the American FAERS database, the high frequency ADRs of Denosumab (Prolia) were hypocalcaemia, bone density abnormal, eczema, rebound effect, spinal deformity, etc. Clinical use of this drug should focus on this part of ADRs. Attention should also be paid to newly discovered ADRs, such as immobile, menopausal symptoms, etc., to avoid more serious consequences. Cohort studies, more detailed and comprehensive case information, and long-term clinical investigations are needed to confirm these results and to further understand the safety profile of Denosumab (Prolia).
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  • 文章类型: Journal Article
    背景:ALK参与D2R的摄取和调节,在不同脑区表达的G蛋白偶联受体。因此,了解ALK抑制剂与癫痫发作之间的关系至关重要。本研究调查了ALK抑制剂与癫痫发作之间的关系。
    方法:本研究通过使用FAERS的不成比例分析来调查ALK抑制剂与癫痫发作之间的关系。目标药物是ALK抑制剂克唑替尼,ceritinib,阿列替尼,布加替尼,还有Lorlatinib.所涵盖的癫痫发作定义为HLGT:\'\'癫痫发作(包括亚型)\'\'包括HLT:\'\'癫痫发作和癫痫发作疾病NEC。\'\'这项研究使用了IC,信号分数,作为不成比例分析的贝叶斯统计方法。
    结果:每种ALK抑制剂的\'\'癫痫发作和癫痫发作障碍的信号评分NEC\'\'为克唑替尼(IC:-0.00052,95%CrI:-0.38-0.27),色瑞替尼(IC:1.18,95%CrI:0.68-1.54),阿来替尼(IC:0.68,95%CrI:0.19-1.02),布加替尼(IC:1.04,95%CrI:0.32-1.54),和氯拉替尼(IC:0.82,95%CrI:0.11-1.32)。另一方面,\'\'广义强直阵挛性癫痫发作\'\',\'\'部分单纯性癫痫发作NEC,\'\'\'\'\'失神癫痫发作,\'\'和\'\'部分复杂发作\'\'没有或很少报告病例,没有检测到信号.
    结论:据我们所知,这是第一份使用上市后监测数据评估ALK抑制剂与癫痫发作之间关系的报告.这些结果表明,色瑞替尼,阿列替尼,布加替尼,和lorlatinib,是高度脑迁移的药物,与癫痫发作有关。
    BACKGROUND: Anaplastic lymphoma kinase (ALK) has been to be involved in the uptake and regulation of dopamine 2 receptor (D2R), a G protein-coupled receptor expressed in various brain regions. Therefore, it is crucial to understand the relationship between ALK inhibitors and seizures is an important issue. This study investigated the relationship between ALK inhibitors and seizures.
    METHODS: This study investigated the relationship between ALK inhibitors and seizures through a disproportionality analysis using the US Food and Drug Administration (FDA) Adverse Event Reporting System (FAERS). The target drugs were the ALK inhibitors crizotinib, ceritinib, alectinib, brigatinib, and lorlatinib. The seizures covered were defined high-level group term (HLGT): \"Seizures (incl. subtype)\" including high-level term (HLT): \"seizures and seizure disorders NEC.\" This study used the information component (IC), a signal score, as a Bayesian statistical method for disproportionality analysis. The signal detection criteria used in this study were the same as those reported previously: a lower limit of 95% credible interval (CrI) for IC >0.
    RESULTS: The signal scores of \'\"seizures and seizure disorders not elsewhere classified (NEC)\" \"for each ALK inhibitor were crizotinib (IC: -0.00052, 95% CrI: -0.38-0.27), ceritinib (IC: 1.18, 95% CrI: 0.68-1.54), alectinib (IC: 0.68, 95% CrI: 0.19-1.02), brigatinib (IC: 1.04, 95% CrI: 0.32-1.54), and lorlatinib (IC: 0.82, 95% CrI: 0.11-1.32). On the other hand, \"generalized tonic-clonic seizures,\" \"partial simple seizures NEC,\" \"absence seizures,\" and \"partial complex seizures\" had no or few reported cases, and no signal was detected.
    CONCLUSIONS: To our knowledge, this is the first report to evaluate the relationship between ALK inhibitors and seizures using post-marketing surveillance data. These results suggest that ceritinib, alectinib, brigatinib, and lorlatinib, which are highly brain-migrating drugs, are associated with seizures.
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  • 文章类型: Journal Article
    胰高血糖素样肽-1(GLP-1)受体激动剂(RA)是2型糖尿病最常用的药物之一。临床指南推荐GLP-1RA作为慢性肾脏病患者糖尿病治疗的辅助手段。动脉粥样硬化性心血管疾病的存在或风险,和肥胖。临床试验中观察到的体重减轻已在健康个体中进一步探索,使GLP-1RA成为下一个减肥治疗方案。
    尽管不良事件相对安全,大多数GLP-1RA都带有标签,警告甲状腺癌的风险,基于动物模型和一些人类上市后的案例报告。考虑到这种药物的日益普及及其扩展为新的流行适应症,有必要对最新上市后安全性数据进行进一步审查,以量化甲状腺增生和肿瘤病例.
    来自美国食品和药物管理局(FDA)不良事件报告系统数据库的GLP-1RA患者报告使用报告比值比和95%CI进行分析。
    在这项研究中,我们分析了超过1,800万份来自美国FDA不良事件报告系统的报告,提供的证据表明,与服用钠-葡萄糖协同转运蛋白-2(SGLT-2)抑制剂单药治疗的患者相比,服用GLP-1RA单药治疗的患者发生甲状腺增生和肿瘤的倾向显著增加.
    GLP-1RA,不管指示,与SGLT-2抑制剂相比,甲状腺肿瘤和增生不良事件报告增加了10倍以上。
    UNASSIGNED: Glucagon-like peptide-1 (GLP-1) receptor agonists (RAs) are one of the most commonly used drugs for type 2 diabetes mellitus. Clinical guidelines recommend GLP-1 RAs as an adjunct to diabetes therapy in patients with chronic kidney disease, presence or risk of atherosclerotic cardiovascular disease, and obesity. The weight loss observed in clinical trials has been explored further in healthy individuals, putting GLP-1 RAs on track to be the next weight loss treatment.
    UNASSIGNED: Although the adverse event profile is relatively safe, most GLP-1 RAs come with a labeled boxed warning for the risk of thyroid cancers, based on animal models and some postmarketing case reports in humans. Considering the increasing popularity of this drug class and its expansion into a new popular indication, a further review of the most recent postmarketing safety data was warranted to quantify thyroid hyperplasia and neoplasm instances.
    UNASSIGNED: GLP-1 RA patient reports from the US Food and Drug Administration (FDA) Adverse Event Reporting System database were analyzed using reporting odds ratios and 95% CIs.
    UNASSIGNED: In this study, we analyzed over 18 million reports from the US FDA Adverse Event Reporting System and provided evidence of significantly increased propensity for thyroid hyperplasias and neoplasms in patients taking GLP-1 RA monotherapy when compared to patients taking sodium-glucose cotransporter-2 (SGLT-2) inhibitor monotherapy.
    UNASSIGNED: GLP-1 RAs, regardless of indication, are associated with an over 10-fold increase in thyroid neoplasm and hyperplasia adverse event reporting when compared to SGLT-2 inhibitors.
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  • 文章类型: Journal Article
    目的:描述接受钠-葡萄糖协同转运蛋白-2(SGLT2)抑制剂治疗的2型糖尿病成人长期或复发性酮症酸中毒(KA)的报道病例。
    方法:我们搜索了美国食品和药物管理局(FDA)不良事件报告系统(FAERS)和医学文献,为了识别我们的病例系列和表征延长KA的病例,复发的KA,或持续性酮症,接受SGLT2抑制剂的成人持续性酮尿症和/或持续性糖尿。
    结果:FDA确定了29例长期或复发KA的独特病例,以及相关术语持续性酮症,持续性酮尿症和持续性糖尿,在2022年7月26日之前接受SGLT2抑制剂的患者中。患者的年龄范围为26至85岁。KA的治疗持续时间为3至20天。当胰岛素减少或过渡到皮下途径时,有7例复发性KA。4例患者的动脉pH值为7.0或以下,中位pH值为7.1。长期或复发KA的相关因素包括手术,减少热量摄入,和生酮/碳水化合物限制饮食。62%的患者服用3种或更多的血糖控制药物,包括SGLT2抑制剂。所有患者有足够的随访信息恢复。
    结论:尽管众所周知KA与SGLT2抑制剂相关,本病例系列显示有可能发生长期或复发的KA事件,且结局严重.这些病例更新了FDA的处方信息,以告知处方者这种风险。
    OBJECTIVE: To describe reported cases of prolonged or relapsed ketoacidosis (KA) in adults with type 2 diabetes receiving treatment with sodium-glucose cotransporter-2 (SGLT2) inhibitors.
    METHODS: We performed a search of the U.S. Food and Drug Administration (FDA) Adverse Event Reporting System and medical literature, to identify our case series and to characterize cases of prolonged KA, relapsed KA, or persistent ketonemia, persistent ketonuria and/or persistent glucosuria in adults receiving SGLT2 inhibitors.
    RESULTS: The FDA identified 29 unique cases of prolonged or relapsed KA, as well as related terms persistent ketonemia, persistent ketonuria, and persistent glucosuria, in patients receiving SGLT2 inhibitors through July 26, 2022. The patients ranged in age from 26 to 85 years. Treatment duration of KA ranged from 3 to 20 days. There were 7 cases of relapsed KA when insulin was reduced or transitioned to subcutaneous route. Arterial pH value was 7.0 or below in 4 patients, and the median pH was 7.1. Associated factors for prolonged or relapsed KA included surgery, decreased caloric intake, and ketogenic/carbohydrate restricted diet. A total of 62% of the patients were taking 3 or more glycemic control medications including the SGLT2 inhibitor. All patients with sufficient follow-up information recovered.
    CONCLUSIONS: Although KA is a well-known risk associated with SGLT2 inhibitors, this case series demonstrated the potential for prolonged or recurrent KA events with serious outcomes. These cases informed updates to FDA\'s prescribing information to inform prescribers of this risk.
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