Pharmacovigilance analysis

  • 文章类型: Journal Article
    嵌合抗原受体T细胞(CAR-T)治疗,自2017年FDA批准以来,一种迅速出现的癌症治疗方法获得了势头,涉及对患者T细胞进行基因工程以靶向肿瘤。尽管已经观察到显著的治疗益处,已经报道了危及生命的不良肺部事件.
    使用SAS9.4和MedDRA26.1,我们回顾性分析了来自食品和药物管理局不良事件报告系统(FAERS)数据库的数据,涵盖2017年至2023年期间。分析包括报告赔率比比例报告比信息分量和经验贝叶斯几何平均值,以评估CAR-T细胞疗法与不良肺事件(PAEs)之间的关联。
    FAERS数据库记录了9,400起与CAR-T疗法有关的不良事件(AE),其中940(10%)为PAEs。在这些CAR-T细胞相关的AE中,缺氧是最常见的报道(344例),其次是呼吸衰竭(127例)。值得注意的是,不同的CAR-T细胞治疗与PAEs有不同程度的关联。具体来说,Tisa-cel与严重事件相关,包括呼吸衰竭和缺氧,而Axi-cel与缺氧和呼吸急促密切相关。此外,其他CAR-T疗法,即,Brexu-cel,Liso-cel,Ide-cel,还有Cilta-cel,也与不同的PAEs有关。值得注意的是,这些PAEs大部分发生在治疗后的前30天.不同CAR-T疗法的死亡率各不相同,Tisa-cel的死亡率最高(43.6%),其次是Ide-cel(18.8%)。
    这项研究全面分析了FAERS数据库中报告的CAR-T细胞疗法接受者的PAEs,揭示缺氧等条件,呼吸衰竭,胸腔积液,和肺不张。这些CAR-T细胞治疗相关事件具有临床意义,值得临床医生和研究人员关注。
    UNASSIGNED: Chimeric antigen receptor T-cell (CAR-T) therapy, a rapidly emerging treatment for cancer that has gained momentum since its approval by the FDA in 2017, involves the genetic engineering of patients\' T cells to target tumors. Although significant therapeutic benefits have been observed, life-threatening adverse pulmonary events have been reported.
    UNASSIGNED: Using SAS 9.4 with MedDRA 26.1, we retrospectively analyzed data from the Food and Drug Administration\'s Adverse Event Reporting System (FAERS) database, covering the period from 2017 to 2023. The analysis included the Reporting Odds Ratio Proportional Reporting Ratio Information Component and Empirical Bayes Geometric Mean to assess the association between CAR-T cell therapy and adverse pulmonary events (PAEs).
    UNASSIGNED: The FAERS database recorded 9,400 adverse events (AEs) pertaining to CAR-T therapies, of which 940 (10%) were PAEs. Among these CAR-T cell-related AEs, hypoxia was the most frequently reported (344 cases), followed by respiratory failure (127 cases). Notably, different CAR-T cell treatments demonstrated varying degrees of association with PAEs. Specifically, Tisa-cel was associated with severe events including respiratory failure and hypoxia, whereas Axi-cel was strongly correlated with both hypoxia and tachypnea. Additionally, other CAR-T therapies, namely, Brexu-cel, Liso-cel, Ide-cel, and Cilta-cel, have also been linked to distinct PAEs. Notably, the majority of these PAEs occurred within the first 30 days post-treatment. The fatality rates varied among the different CAR-T therapies, with Tisa-cel exhibiting the highest fatality rate (43.6%), followed by Ide-cel (18.8%).
    UNASSIGNED: This study comprehensively analyzed the PAEs reported in the FAERS database among recipients of CAR-T cell therapy, revealing conditions such as hypoxia, respiratory failure, pleural effusion, and atelectasis. These CAR-T cell therapy-associated events are clinically significant and merit the attention of clinicians and researchers.
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  • 文章类型: Journal Article
    使用蛋白酶体抑制剂(PI),即硼替佐米和卡非佐米,革命性的多发性骨髓瘤(MM)治疗。了解他们独特的不良事件(AE)概况有助于量身定制的治疗计划。
    我们分析了硼替佐米和卡非佐米的FDA不良事件报告系统(FAERS)数据(2012年第一季度至2023年第四季度),利用报告优势比(ROR),比例报告比率(PRR),和贝叶斯置信度传播神经网络(BCPNN)。
    FAERS产生了19,720份硼替佐米和12,252份卡非佐米AE报告。45-65岁的男性表现出更高的AE易感性。常见的AE系统包括感染,神经系统疾病,血液疾病,一般疾病,心脏病,和肾脏疾病。新的硼替佐米信号为脓毒症和结肠炎。卡非佐米表现出升高的心脏和肾脏毒性,但减少了周围神经病变和血小板减少症。
    FAERS分析显示新的AE信号(败血症,结肠炎)用于硼替佐米,并强调卡非佐米与硼替佐米相比心脏和肾脏风险增加。平衡PI的利益和风险对于临床决策至关重要。
    UNASSIGNED: The use of proteasome inhibitors (PIs), namely Bortezomib and Carfilzomib, revolutionized multiple myeloma (MM) treatment. Understanding their distinct adverse event (AE) profiles aids in tailored treatment plans.
    UNASSIGNED: We analyzed FDA Adverse Event Reporting System (FAERS) data (Q1 2012-Q4 2023) for Bortezomib and Carfilzomib, utilizing reporting odds ratio (ROR), proportional reporting ratio (PRR), and Bayesian confidence propagation neural network (BCPNN).
    UNASSIGNED: FAERS yielded 19,720 Bortezomib and 12,252 Carfilzomib AE reports. Males aged 45-65 exhibited higher AE susceptibility. Common AE systems included Infections, Nervous System Disorders, Blood Disorders, General Disorders, Cardiac Disorders, and Renal Disorders. New Bortezomib signals were sepsis and colitis. Carfilzomib exhibited elevated cardiac and renal toxicity but reduced peripheral neuropathy and thrombocytopenia.
    UNASSIGNED: FAERS analysis revealed new AE signals (sepsis, colitis) for Bortezomib and highlighted Carfilzomib\'s heightened cardiac and renal risks compared to Bortezomib. Balancing PIs\' benefits and risks is crucial for clinical decision-making.
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  • 文章类型: Journal Article
    背景:Nusinersen是第一种精确靶向治疗脊髓性肌萎缩的药物,一种罕见的疾病,发生在10,000至20,000个活产婴儿中。因此,关于nusinersen的安全性的全面和全面的报告,现实世界的人口是必要的。本研究旨在通过食品和药物管理局不良事件报告系统(FAERS)数据库挖掘与nusinersen相关的不良事件(AE)信号。
    方法:我们在2016年12月至2023年3月期间从FAERS提取了以nusinersen为主要嫌疑人的不良事件报告。报告比值比(ROR)和贝叶斯置信度传播神经网络(BCPNN)用于AE信号检测。
    结果:我们从FAERS数据库中提取了4807例疑似AE病例,其中nusinersen为主要嫌疑人。其中,使用ROR和BCPNN获得106个阳性信号。报告的全身器官类别频率最高的是一般疾病和给药部位状况。在FAERS数据库中检测到nusinersen的常见临床AE,比如肺炎,呕吐,背痛,头痛,发热,和腰椎穿刺后综合征.此外,我们通过不成比例分析确定了潜在的意外严重不良事件,包括败血症,癫痫发作,癫痫,脑损伤,心肺骤停,还有心脏骤停.
    结论:分析来自FAERS数据库的大量实际数据,我们通过不成比例分析确定了nusinersen的潜在新AE。对于卫生保健专业人员和药剂师来说,专注于有效管理nusinersen的高风险AE是有利的,提高临床环境中的药物水平,维护患者用药安全。
    BACKGROUND: Nusinersen is the first drug for precise targeted therapy of spinal muscular atrophy, a rare disease that occurs in one of 10,000 to 20,000 live births. Therefore, thorough and comprehensive reports on the safety of nusinersen in large, real-world populations are necessary. This study aimed to mine the adverse event (AE) signals related to nusinersen through the Food and Drug Administration Adverse Event Reporting System (FAERS) database.
    METHODS: We extracted reports of AEs with nusinersen as the primary suspect from FAERS between December 2016 and March 2023. Reporting odds ratio (ROR) and Bayesian confidence propagation neural network (BCPNN) were used for AE signal detection.
    RESULTS: We extracted a total of 4807 suspected AE cases with nusinersen as the primary suspect from the FAERS database. Among them, 106 positive signals were obtained using the ROR and BCPNN. The highest frequency reported systemic organ class was general disorders and administration site conditions. Common clinical AEs of nusinersen were detected in the FAERS database, such as pneumonia, vomiting, back pain, headache, pyrexia, and post-lumbar puncture syndrome. In addition, we identified potential unexpected serious AEs through disproportionality analysis, including sepsis, seizure, epilepsy, brain injury, cardiorespiratory arrest, and cardiac arrest.
    CONCLUSIONS: Analyzing large amounts of real-world data from the FAERS database, we identified potential new AEs of nusinersen by disproportionate analysis. It is advantageous for health care professionals and pharmacists to concentrate on effectively managing high-risk AEs of nusinersen, improve medication levels in clinical settings, and uphold patient medication safety.
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  • 文章类型: Journal Article
    背景:贝伐单抗(Bevacizumab,BV)广泛应用于肿瘤的常规治疗和临床治疗。本研究旨在通过挖掘美国食品和药物管理局不良事件报告系统(FAERS)数据库中的数据,描述和分析不同BV治疗方案报告的上市后肺出血和咯血病例。方法:数据收集自2004年第一季度至2023年第一季度的FAERS数据库。包括报告比值比(ROR)在内的不成比例分析用于量化与BV相关治疗方案相关的肺出血和咯血不良事件(AE)的不成比例报告信号。人口特征,进一步阐明起病时间和结局.结果:从FAERS数据库中提取了55,184份BV相关报告,其中497例报告与肺出血和咯血有关。总的来说,肺出血和咯血AE的中位发病时间为43天(四分位距(IQR)15~117天).在亚组分析中,BV加靶向治疗的最长中位发病时间为90.5天(IQR34-178.5天),而BV加化疗最短,为40.5天(IQR14-90.25)。BV加化疗不成比例地报告了最高的死亡百分比(292例病例中有148例死亡,50.68%)。此外,在我们的研究中,包括4个亚组在内的BV相关治疗显示阳性信号与肺出血和咯血的不成比例报告相关.值得注意的是,与BV单一疗法相比,BV加化疗在肺出血和咯血信号的报告风险明显更高(ROR5.35[95%CI,4.78-6.02]vs.ROR4.19[95%CI,3.56-4.91],p=0.0147)。结论:本研究以肺出血和咯血的报告为特征,以及不同BV相关治疗方案的发病时间和人口统计学特征。为BV的进一步研究和临床实践提供了有价值的证据。
    Background: Bevacizumab (BV) is widely used in routine cancer treatment and clinical therapy in combination with many other agents. This study aims to describe and analyse post-market cases of pulmonary haemorrhage and haemoptysis reported with different BV treatment regimens by mining data from the United States Food and Drug Administration Adverse Event Reporting System (FAERS) database. Methods: Data were collected from the FAERS database between 2004 Q1 and 2023 Q1. Disproportionality analysis including the reporting odds ratio (ROR) was employed to quantify the signals of disproportionate reporting of pulmonary haemorrhage and haemoptysis adverse events (AEs) associated with BV-related treatment regimens. The demographic characteristics, time to onset and outcomes were further clarified. Results: A total of 55,184 BV-associated reports were extracted from the FAERS database, of which 497 reports related to pulmonary haemorrhage and haemoptysis. Overall, the median onset time of pulmonary haemorrhage and haemoptysis AEs was 43 days (interquartile range (IQR) 15-117 days). In the subgroup analysis, BV plus targeted therapy had the longest median onset time of 90.5 days (IQR 34-178.5 days), while BV plus chemotherapy had the shortest of 40.5 days (IQR 14-90.25). BV plus chemotherapy disproportionately reported the highest percentage of death (148 deaths out of 292 cases, 50.68%). Moreover, the BV-related treatments including four subgroups in our study demonstrated the positive signals with the association of disproportionate reporting of pulmonary haemorrhage and haemoptysis. Notably, BV plus chemotherapy showed a significant higher reporting risk in pulmonary haemorrhage and haemoptysis signals of disproportionate reporting in comparison to BV monotherapy (ROR 5.35 [95% CI, 4.78-6.02] vs. ROR 4.19 [95% CI, 3.56-4.91], p = 0.0147). Conclusion: This study characterized the reporting of pulmonary haemorrhage and haemoptysis, along with the time to onset and demographic characteristics among different BV-related treatment options. It could provide valuable evidence for further studies and clinical practice of BV.
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  • 文章类型: Journal Article
    本研究的目的是使用美国食品和药物管理局不良事件报告系统(FAERS)数据库研究三种转甲状腺素(TTR)抑制剂在现实世界中的药物安全性。
    本研究提取了FAERS数据库从2018年第一季度到2023年第三季度收到的报告,以进行描述性分析和不相称性分析。使用报告比值比(ROR)在首选术语(PT)水平和系统器官分类(SOC)水平进行安全信号挖掘。使用Weibull形状参数(WSP)分析了开始时间曲线的特征。使用Kaplan-Meier方法评估TTR抑制剂的累积发生率。根据报告者是否是医学专业人员进行亚组分析。
    共提取了3,459例作为主要可疑(PS)药物的TTR抑制剂引起的不良事件(AE)报告。患者报告的不良事件前三名是疲劳,虚弱,坠落,最出乎意料的强关联是非特异性反应。vutrisiran报告的前三个AE为下降,四肢疼痛和不适,与最意想不到的强烈关联是硬膜下血肿。inotersen报告的不良事件前三名是血小板计数下降,血肌酐升高,和疲劳,最出乎意料的强烈关联是血白蛋白下降。维生素A减少,关节痛,和呼吸困难是所有三种药物的药物标签中提到的相同的不良事件,而不适和虚弱是相同的意外显著信号。这项研究提供了与TTR抑制剂相关的AE的发病时间特征的变异性的证据。以及医疗专业人员和非医疗专业人员在不良事件报告方面存在差异的证据。
    总之,我们使用FAERS数据库比较了三种TTR抑制剂在现实世界中药物安全性的异同.结果表明,这三种药物不仅具有共同的不良事件,但它们在药物安全性方面也表现出差异。这项研究有助于提高医学专业人员对TTR抑制剂安全性的理解。
    UNASSIGNED: The purpose of this study is to investigate the drug safety of three Transthyretin (TTR) inhibitors in the real world using the United States Food and Drug Administration Adverse Event Reporting System (FAERS) database.
    UNASSIGNED: This study extracted reports received by the FAERS database from the first quarter of 2018 to the third quarter of 2023 for descriptive analysis and disproportionality analysis. Safety signal mining was conducted at the Preferred Term (PT) level and the System Organ Class (SOC) level using reporting odds ratio (ROR). The characteristics of the time-to-onset curves were analyzed using the Weibull Shape Parameter (WSP). The cumulative incidence of TTR inhibitors was evaluated using the Kaplan-Meier method. Subgroup analyses were conducted based on whether the reporter was a medical professional.
    UNASSIGNED: A total of 3,459 reports of adverse events (AEs) caused by TTR inhibitors as the primary suspect (PS) drug were extracted. The top three reported AEs for patisiran were fatigue, asthenia, and fall, with the most unexpectedly strong association being nonspecific reaction. The top three reported AEs for vutrisiran were fall, pain in extremity and malaise, with the most unexpectedly strong association being subdural haematoma. The top three reported AEs for inotersen were platelet count decreased, blood creatinine increased, and fatigue, with the most unexpectedly strong association being blood albumin decreased. Vitamin A decreased, arthralgia, and dyspnea were the same AEs mentioned in the drug labels of all three drugs, while malaise and asthenia were the same unexpected significant signals. This study offers evidence of the variability in the onset time characteristics of AEs associated with TTR inhibitors, as well as evidence of differences in adverse event reporting between medical professionals and non-medical professionals.
    UNASSIGNED: In summary, we compared the similarities and differences in drug safety of three TTR inhibitors in the real world using the FAERS database. The results indicate that not only do these three drugs share common AEs, but they also exhibit differences in drug safety profiles. This study contributes to enhancing the understanding of medical professionals regarding the safety of TTR inhibitors.
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  • 文章类型: Journal Article
    5型磷酸二酯酶(PDE5)抑制剂通常用于勃起功能障碍和肺动脉高压。虽然PDE5抑制剂在其预期的治疗领域显示出显著的疗效,人们对其潜在的眼部不良事件感到担忧.我们的研究旨在表征PDE5抑制剂的眼部安全性,并探讨PDE5抑制剂之间眼部不良事件的差异。
    我们分析了与西地那非相关的眼部不良事件的报告,伐地那非和他达拉非从2004年第一季度到2023年第一季度提交给FDA不良事件报告系统(FAERS)数据库。进行不相称性分析以评估报告风险概况。
    在符合分析条件的61,211份报告中,5,127涉及西地那非,832伐地那非,和3,733他达拉非.所有PDE5抑制剂显示眼部不良事件的报告比值比(ROR)增加,伐地那非最高(ROR4.47),其次是西地那非和他达拉非。关键的眼部不良事件包括氰视,视神经缺血性神经病,视野缺陷,单侧失明和失明。西地那非对色盲的比例最高(ROR1148.11),而伐地那非和他达拉非对视神经缺血性病变的比例最高。发病时间分析也显示出显著差异,与伐地那非和他达拉非相比,西地那非的中位发病时间较晚。
    这项全面的药物警戒研究揭示了与西地那非相关的眼部不良事件的不同模式,伐地那非,还有他达拉非.这些发现有助于更好地了解PDE5抑制剂的安全性,并可能指导医疗保健专业人员进行临床决策。
    UNASSIGNED: Our study aims to characterize the ocular safety profiles of phosphodiesterase type 5 (PDE5) inhibitors and explore the differences among different PDE5 inhibitors.
    UNASSIGNED: We analyzed reports on ocular adverse events associated with sildenafil, vardenafil and tadalafil submitted to the FDA Adverse Event Reporting System (FAERS) database from the first quarter of 2004 to the first quarter of 2023. Disproportionality analysis was conducted to evaluate reporting risk profiles.
    UNASSIGNED: Among 61,211 reports qualifying for analysis, 5,127 involved sildenafil, 832 vardenafil, and 3,733 tadalafil. All PDE5 inhibitors showed increased reporting odds ratios (ROR) for ocular adverse events, with vardenafil highest (ROR 4.47) followed by sildenafil and tadalafil. Key ocular adverse events included cyanopsia, optic ischemic neuropathy, visual field defects, unilateral blindness and blindness. Sildenafil showed the highest disproportionality for cyanopsia (ROR 1148.11) while vardenafil and tadalafil showed the highest disproportionality for optic ischemic neuropathy. Time-to-onset analysis also revealed significant differences, with sildenafil having a later median time-to-onset compared to vardenafil and tadalafil.
    UNASSIGNED: This comprehensive pharmacovigilance study reveals distinct patterns of ocular adverse events associated with PDE5 inhibitors. These findings contribute to a better understanding of the safety profiles of PDE5 inhibitors and may guide healthcare professionals in clinical decision-making.
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  • 文章类型: Journal Article
    背景:尼拉帕尼在卵巢癌的治疗中起着至关重要的作用。全面了解与尼拉帕尼相关的高血压的发生率和风险对医疗保健从业人员至关重要。
    方法:在本研究中,一个观察,回顾性,药物警戒研究基于FDA不良事件报告系统(FAERS)数据库进行.从2017年第一季度(Q1)到2023年Q1,提取与尼拉帕尼相关的高血压病例进行不成比例分析。此外,使用发表在PubMed上的关于尼拉帕尼治疗癌症的随机对照试验(RCT)进行了单独的荟萃分析,Embase,和WebofScience从成立到5月31日,2023年。主要结果是与尼拉帕尼相关的高血压的发生率和风险。
    结果:在FAERS中,发现1196例高血压与尼拉帕尼治疗有关。值得注意的是,尼拉帕利表现出最高水平的不相称性,如报告优势比(ROR)2.85(95%CI,2.69-3.01)所示,提示与其他多聚ADP-核糖聚合酶(PARP)抑制剂相比,引起高血压的可能性更大(P<0.01)。我们的安全性荟萃分析包括报告高血压的尼拉帕尼的五个关键随机对照试验。与安慰剂治疗相比,荟萃分析显示尼拉帕尼组高血压风险显著增加(OR2.84[95%CI,2.17-3.72],P<0.01),在研究中没有观察到异质性(I2=0%,χ2=2.02,P=0.73)。尼拉帕尼诱发高血压的发生率为16.9%(95%CI,14.9-18.9;I2=34%)。
    结论:这些研究结果表明,与其他PARP抑制剂相比,高血压是与尼拉帕尼相关的独特不良事件。尼拉帕尼显着增加高血压的风险,需要在临床药物中早期识别和管理。
    Niraparib plays a crucial role in the treatment of ovarian cancer. A comprehensive understanding of the incidence and risk of hypertension associated with niraparib would be of vital importance to healthcare practitioners.
    In this study, an observational, retrospective, pharmacovigilance study was conducted based on the FDA Adverse Event Reporting System (FAERS) database. Cases of hypertension related to niraparib were extracted for disproportionality analysis from the first quarter (Q1) of 2017 to Q1 of 2023. Moreover, a separate meta-analysis was performed using the randomized controlled trials (RCTs) on niraparib for cancer treatment published in PubMed, Embase, and Web of Science from inception to May 31st, 2023. The primary outcomes were the incidence and risk of hypertension associated with niraparib.
    In the FAERS, 1196 hypertension cases were found to be related to niraparib treatment. Notably, niraparib exhibited the highest level of disproportionality, as indicated by a reporting odds ratio (ROR) of 2.85 (95% CI, 2.69-3.01), suggesting a greater likelihood of causing hypertension compared to other poly-ADP-ribose polymerase (PARP) inhibitors (P < 0.01). Our safety meta-analysis included five pivotal RCTs of niraparib that reported hypertension. In comparison to placebo treatment, the meta-analysis demonstrated a significant increase in the risk of hypertension with niraparib (OR 2.84 [95% CI, 2.17-3.72], P < 0.01), with no heterogeneity observed among the studies (I2 = 0%, χ2 = 2.02, P = 0.73). The incidence of niraparib-induced hypertension was determined to be 16.9% (95% CI, 14.9-18.9; I2 = 34%).
    These findings suggest that hypertension is a distinctive adverse event associated with niraparib compared to other PARP inhibitors. Niraparib significantly increases the risk of hypertension that needs early recognition and management in clinical medication.
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  • 文章类型: Journal Article
    背景:最近关于个体在使用利拉鲁肽和司马鲁肽时经历自杀和/或自我伤害行为的报道增加了对胰高血糖素样肽-1激动剂(GLP-1RA)的神经精神安全性的担忧。由于现实世界的证据非常有限,我们通过挖掘FDA不良事件报告系统(FAERS)数据库,探索了GLP-1RA与自杀/自伤之间的关联.
    方法:FAERS数据库在2005年第二季度至2023年第二季度进行了查询。使用报告赔率比(ROR)和经验贝叶斯几何平均值(EBGM)进行不成比例分析。
    结果:在研究期间,FAERS报告了534例GLP-1RA相关的自杀/自伤病例。GLP-1RA并未导致总体自杀和自我伤害病例的不成比例的增加(ROR:0.16,95CI0.15-0.18,P<0.001;EBGM05:0.15)。分层分析在女性和男性中都没有发现GLP-1RA自杀/损伤的安全信号。儿童GLP-1RA自杀/自伤的ROR略有升高(ROR:2.50,95CI1.02-6.13,P=0.05),而EBGM05在该人群中<2。在其他年龄组中没有观察到显著的信号值。在COVID-19大流行爆发之前或之后,GLP-1RA均未发现过度报告自杀/自我伤害。
    结论:报告给FAERS的自杀或自伤病例目前没有任何可归因于GLP-1RA的总体安全性信号。亚组分析显示,儿童GLP-1RA自杀和自我损伤的ROR边缘升高,但EBGM05在该人群中未检测到安全信号。仍有必要进行进一步的大规模前瞻性调查以进一步证实这一发现。
    Recent reports of individuals experiencing suicidal and/or self-injurious behaviors while using liraglutide and semaglutide have heightened the concerns regarding neuropsychiatric safety of Glucagon-like peptide-1 agonists (GLP-1RAs). As real-world evidence is very limited, we explored the association between GLP-1RA and suicide/self-injury by mining the FDA Adverse Event Reporting System (FAERS) database.
    The FAERS database was queried from 2005 Q2 to 2023 Q2. The Reporting Odds Ratio (ROR) and Empirical Bayes Geometric Mean (EBGM) were used to conduct the disproportionality analysis.
    A total of 534 GLP-1RA-associated suicide/self-injury cases were reported in the FAERS during the study period. GLP-1RA did not cause a disproportionate increase in overall suicidal and self-injurious cases (ROR: 0.16, 95%CI 0.15-0.18, P < 0.001; EBGM05: 0.15). Stratified analyses found no safety signal of suicide/injury for GLP-1RA in both females and males. The ROR for suicide/self-injury with GLP-1RA was slightly elevated (ROR: 2.50, 95%CI 1.02-6.13, P = 0.05) in children, while the EBGM05 was < 2 in this population. No significant signal value was observed in other age groups. No over-reporting of suicide/self-injury was identified for GLP-1RA before or after the COVID-19 pandemic outbreak.
    The cases of suicide or self-injury reported to FAERS do not indicate any overall safety signal attributable to GLP-1RA at this time. Subgroup analysis revealed a marginal elevation of ROR for suicide and self-injury with GLP-1RA in children, but no safety signal was detected by EBGM05 in this population. Further large-scale prospective investigations are still warranted to further confirm this finding.
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  • 文章类型: Journal Article
    目的:万古霉素和利奈唑胺是预防和治疗耐甲氧西林金黄色葡萄球菌(MRSA)感染的一线药物。当利奈唑胺诱导的血小板减少症发生时,万古霉素是众所周知的最佳替代药物。然而,几例万古霉素诱导的血小板减少症,尤其是出血并发症,最近有报道称,这引起了人们的注意。这项研究的目的是评估万古霉素与血小板减少症出血并发症之间的潜在相关性。
    方法:这是一项真实世界的药物警戒研究,于2022年10月使用美国食品和药物管理局不良事件报告系统(FAERS)数据库进行。我们进行了不成比例分析,通过计算报告比值比(ROR)和信息成分(IC)来评估万古霉素诱导的血小板减少症出血并发症的风险。其中弱信号定义为IC95%CI的下限为0至1.5,中间信号定义为IC95%CI的下限为1.5至3.0,强信号定义为IC95%CI的下限为>3.0。
    结果:FAERS数据库中有21,854例病例将万古霉素列为2004年第1季度至2022年第2季度的可疑药物。万古霉素致血小板减少800例,万古霉素致血小板减少125例出血并发症。替考拉宁,替加环素,万古霉素(3个中间信号)与血小板减少症的相关性低于利奈唑胺(强信号)。然而,血小板减少症出血并发症与万古霉素显著相关(ROR=9.641;95%CI,8.105-11.468;IC=3.184;95%CI,2.929-3.440[中间信号]),其次是利奈唑胺(ROR=9.350;95%CI,7.318-11.947;IC=3.106;95%CI,2.745-3.466[中间信号]),替考拉宁(ROR=6.399;95%CI,2.869-14.272;IC=2.059;95%CI,0.881-3.283[弱信号]),和达托霉素(ROR=2.784;95%CI,1.496-5.180;IC=1.287;95%CI,0.374-2.201[弱信号])。替加环素和达托霉素是最不可能引起血小板减少的抗MRSA药物(中信号和弱信号,分别)和血小板减少症的出血并发症(无信号和弱信号,分别)。除年龄<45~≥80岁(弱信号)外,所有组均出现万古霉素所致血小板减少症出血并发症的中间信号。
    结论:血小板减少症的出血并发症与万古霉素的使用显著相关,在所有抗MRSA药物中,风险最高。医生应该意识到这种可能的严重不良反应。
    Vancomycin and linezolid are first-line drugs used for the prophylaxis and treatment of methicillin-resistant Staphylococcus aureus (MRSA) infections. Vancomycin is well known as the best alternative drug when linezolid-induced thrombocytopenia occurs. However, several cases with vancomycin-induced thrombocytopenia, especially with bleeding complications, have been reported recently, which has attracted attention. The objective of this study is to assess the potential relevance between vancomycin and bleeding complications in thrombocytopenia.
    This is a real-world pharmacovigilance study conducted in October 2022 using the US Food and Drug Administration Adverse Event Reporting System (FAERS) database. We performed a disproportional analysis to assess the risk of bleeding complications in vancomycin-induced thrombocytopenia by calculating reporting odds ratios (RORs) and information components (ICs), with a weak signal defined as a lower limit of the IC 95% CI of 0 to 1.5, a middle signal defined as a lower limit of the IC 95% CI of 1.5 to 3.0, and a strong signal defined as a lower limit of the IC 95% CI of >3.0.
    There were 21,854 cases in the FAERS database that listed vancomycin as a suspected drug from quarter 1 of 2004 to quarter 2 of 2022. There were 800 cases of vancomycin-induced thrombocytopenia and 125 cases of bleeding complications in vancomycin-induced thrombocytopenia. Teicoplanin, tigecycline, and vancomycin (3 middle signals) were sequentially less associated with thrombocytopenia than linezolid (strong signal). However, bleeding complications in thrombocytopenia were significant associated with vancomycin (ROR = 9.641; 95% CI, 8.105-11.468; IC = 3.184; 95% CI, 2.929-3.440 [middle signal]), followed by linezolid (ROR = 9.350; 95% CI, 7.318-11.947; IC = 3.106; 95% CI, 2.745-3.466 [middle signal]), teicoplanin (ROR = 6.399; 95% CI, 2.869-14.272; IC = 2.059; 95% CI, 0.881-3.283 [weak signal]), and daptomycin (ROR = 2.784; 95% CI, 1.496-5.180; IC = 1.287; 95% CI, 0.374-2.201 [weak signal]). Tigecycline and daptomycin were the least likely anti-MRSA drug to cause thrombocytopenia (middle signal and weak signal, respectively) and bleeding complications in thrombocytopenia (no signal and weak signal, respectively). Middle signals of bleeding complication in vancomycin-induced thrombocytopenia were found in all group except those <45 to ≥80 years of age (weak signal).
    Bleeding complications in thrombocytopenia were significantly associated with vancomycin use, and the risk was highest among all the anti-MRSA drugs. Physicians should be aware of this possible serious adverse reaction.
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  • 文章类型: Journal Article
    分析识别奥希替尼相关不良事件(ADE)的性别差异信号,为临床实施个体化用药提供参考。
    提取了从FAERS数据库收到的2016年第一季度至2022年第四季度奥希替尼的ADE报告。报告奇数比(ROR)数据分析策略用于挖掘代表与奥希替尼相关的ADE的性别差异的信号强度。
    分析中包括的奥希替尼ADE报告数量为7968例女性和7570例男性,分别。根据ROR,男性更容易患肺炎吸入性,肺部感染,间质性肺病,肺毒性,呼吸困难,室性早搏,和肺血栓形成,虽然女性更容易出现充血性心力衰竭,口腔炎,腹泻,肌肉痉挛,指甲疾病,甲状腺溶解症,皮肤病,皮肤干燥,和皮疹。
    与奥希替尼相关的ADE信号存在性别差异。男性患者发生ADE的风险较高的是肺部疾病,似乎比女性患者发生的指甲毒性或皮肤问题更严重。为了保证用药安全,应警惕不同性别之间的差异,采取相应的预防措施,减少严重ADE的发生。
    UNASSIGNED: We analyze and identify the signals of gender differences in adverse events (ADEs) related to Osimertinib and provide reference for clinical implementation of individualized drug use.
    UNASSIGNED: ADE reports of Osimertinib received from FAERS database from the first quarter of 2016 to the fourth quarter of 2022 were extracted. Reporting odds ratio (ROR) data analysis strategy was used for mining of signal strength that represents gender differences in ADEs related to Osimertinib.
    UNASSIGNED: The number of Osimertinib ADE reports included in the analysis was 7968 in females and 7570 in males, respectively. According to ROR, men were more likely to develop pneumonia aspiration, lung infection, interstitial lung disease, pulmonary toxicity, dyspnea, ventricular extrasystoles, and pulmonary thrombosis, while women were more likely to develop cardiac failure congestive, stomatitis, diarrhea, muscle spasms, nail disorder, onycholysis, skin disorder, dry skin, and rash.
    UNASSIGNED: Gender differences existed in ADE signals related to Osimertinib. The higher risk of ADEs in male patients was lung diseases that seem more serious than those nail toxicities or skin problems that occurred in female patients. In order to ensure the safety of medication, we should be alert to the differences between different genders and take corresponding preventive measures to reduce the occurrence of serious ADEs.
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