post‐marketing surveillance

  • 文章类型: Journal Article
    临床试验证明了阿普瑞司特治疗银屑病的安全性和有效性,包括日本患者。这项上市后监测研究是在2016年日本批准apremalast后进行的,目的是在常规临床实践中评估该药物在日本斑块状银屑病(PsO)和银屑病关节炎(PsA)患者中的安全性和有效性。患者(在2017年9月1日至2019年8月31日之间注册),在apremilast治疗开始或直至停药或停药后观察12个月。通过评估不良反应(ARs)和严重ARs来评估安全性。PsO的有效性指标包括在治疗6个月和12个月后,实现全球改善和医师全球评估(PGA)评分为0/1的患者比例以及皮肤病生活质量指数(DLQI)相对于基线的变化。安全性分析集包括1063名患者(PsO,n=992;PsA,n=127)。在29.4%和0.7%的患者中报告了ARs和严重ARs,分别;大多数发生在apremilast开始后<1个月。没有致命AR的报告,严重感染,超敏反应,或者血管炎.没有发现新的安全信号。在关键调查项目中,胃肠道疾病是最常见的ARs(21.3%).在PsO患者中,经过6个月和12个月的治疗,实现高效或有效整体改善的有效率分别为90.9%和93.8%;42.7%和58.1%的患者实现PGA0/1;总DLQI评分从基线平均下降为4.2(p<0.0001)和5.7(p<0.0001),分别。在少数PsA患者中进行了一些措施的有效性评估;治疗6个月和12个月后,观察到全球改善有效率的改善,28关节评分中的疾病活动评分,视觉模拟量表评分,和DLQI得分。我们得出的结论是,口服apremilast在本上市后监测研究中招募的日本PsO和/或PsA患者中具有良好的耐受性和有效性。
    The safety and efficacy of apremilast in psoriatic disease has been demonstrated in clinical trials, including in Japanese patients. This post-marketing surveillance study was conducted after approval of apremalast in Japan in 2016 to evaluate the safety and effectiveness of the drug in Japanese patients with plaque psoriasis (PsO) and psoriatic arthritis (PsA) in routine clinical practice. Patients (enrolled between September 1, 2017, and August 31, 2019), were observed for 12 months after apremilast treatment initiation or until discontinuation or withdrawal. Safety was assessed by evaluating adverse reactions (ARs) and serious ARs. Effectiveness measures in PsO included the proportion of patients who achieved global improvement and Physician\'s Global Assessment (PGA) scores of 0/1 and the change from baseline in the Dermatology Life Quality Index (DLQI) after 6 and 12 months treatment. The safety analysis set included 1063 patients (PsO, n = 992; PsA, n = 127). ARs and serious ARs were reported in 29.4% and 0.7% of patients, respectively; most occurred <1 month after apremilast initiation. There were no reports of fatal ARs, serious infections, hypersensitivity, or vasculitis. No new safety signals were identified. Among the key survey items, gastrointestinal disorders were the most common ARs (21.3%). In patients with PsO, after 6 and 12 months of treatment, effectiveness rates of achieving highly effective or effective global improvement of were 90.9% and 93.8%; PGA 0/1 was achieved by 42.7% and 58.1% of patients; mean decrease from baseline in total DLQI score was 4.2 (p < 0.0001) and 5.7 (p < 0.0001), respectively. Effectiveness was evaluated in a small number of patients with PsA for some measures; after 6 and 12 months of treatment, improvements were observed in global improvement effectiveness rates, Disease Activity Score in 28 Joints score, Visual Analog Scale score, and DLQI score. We conclude that orally administered apremilast was well tolerated and effective in Japanese patients with PsO and/or PsA enrolled in this post-marketing surveillance study.
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  • 文章类型: Journal Article
    背景:Anamorelin于2021年在日本被批准用于治疗与非小细胞肺相关的癌症恶病质,胃,胰腺,或结直肠癌。正在进行上市后监测,以评估anamorelin的实际安全性和有效性。
    方法:这种前瞻性,观察性监测登记了所有在2021年4月21日之后开始接受anamorelin治疗的患者.高血糖症,肝功能损害,传导障碍,与治疗相关的不良事件被定义为主要安全规范.体重(BW)和食欲被评估为有效性规格。
    结果:此分析基于截至2023年1月21日的数据。安全性和有效性分析集包括6016和4511名患者,分别。≥1%患者的治疗相关不良事件为高血糖(3.9%)和恶心(2.6%)。高血糖的发生率,肝功能损害,传导障碍,与治疗相关的不良事件为4.8%,1.2%,1.1%,分别。从基线到第3、12、24和52周的平均BW变化(标准误差[SE])为0.64(0.05)kg,1.19(0.12)kg,1.40(0.21)kg,和1.42(0.39)千克,分别。从基线到第3、12、24和52周,厌食症/恶病质治疗功能评估5项厌食症症状量表总分的平均变化(SE)为3.2(0.09),4.8(0.18),5.2(0.30),和5.3(0.47),分别,超过临床意义的改善评分(2.0分)。
    结论:阿纳瑞林的整体安全性没有引起新的安全性问题,尽管高血糖和恶心可能需要持续谨慎。在真实世界的临床环境中也观察到BW和食欲的改善。
    BACKGROUND: Anamorelin was approved in Japan in 2021 to treat cancer cachexia associated with non-small cell lung, gastric, pancreatic, or colorectal cancers. Post-marketing surveillance is being conducted to evaluate the real-world safety and effectiveness of anamorelin.
    METHODS: This prospective, observational surveillance registered all patients who started treatment with anamorelin after April 21, 2021. Hyperglycemia, hepatic impairment, conduction disorders, and their associated adverse events related to treatment were defined as main safety specifications. Body weight (BW) and appetite were assessed as effectiveness specifications.
    RESULTS: This analysis was based on data as of January 21, 2023. The safety and effectiveness analysis sets included 6016 and 4511 patients, respectively. Treatment-related adverse events in ≥1% of patients were hyperglycemia (3.9%) and nausea (2.6%). The incidences of hyperglycemia, hepatic impairment, conduction disorders, and their associated adverse events related to treatment were 4.8%, 1.2%, and 1.1%, respectively. The mean changes (standard error [SE]) in BW from baseline to weeks 3, 12, 24, and 52 were 0.64 (0.05) kg, 1.19 (0.12) kg, 1.40 (0.21) kg, and 1.42 (0.39) kg, respectively. The mean changes (SE) in Functional Assessment of Anorexia/Cachexia Treatment 5-item Anorexia Symptom Scale total scores from baseline to weeks 3, 12, 24, and 52 were 3.2 (0.09), 4.8 (0.18), 5.2 (0.30), and 5.3 (0.47), respectively, exceeding the clinically meaningful improvement score (2.0 points).
    CONCLUSIONS: The overall safety of anamorelin raised no new safety concerns, although continued caution may be required for hyperglycemia and nausea. Improvements in BW and appetite were also observed in real-world clinical settings.
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  • 文章类型: Journal Article
    目的:本中期报告提供了一项为期12周的上市后监测结果,评估了去氨加压素口服崩解片25和50μg在日本男性夜间多尿症患者中的安全性。
    方法:在计划的1000名日本男性因夜间多尿症首次接受去氨加压素治疗的研究人群中,纳入971例。在这个中期分析中,9例,包括6起违反登记的事件和3起未经证实的去氨加压素给药的事件,在2021年12月底之前收集和固定的354份病例报告表中排除,345例病例给药后12周的数据被定义为安全性分析集.
    结果:平均年龄为74.5±9.9岁,88.7%的调查参与者年龄≥65岁。153例(44.3%)以25μg的剂量开始去氨加压素。71例报告药物不良反应(ADR)102例,其中严重不良反应6例3例(0.9%)。最常见的不良反应为低钠血症29例(8.4%)。低钠血症病例中有8例无症状。29例低钠血症中有13例在发病4周内症状缓解或略有改善。此外,217例中有11例(5.1%)发生低钠血症,给予去氨加压素前的血清钠水平≥140mmol/L,87例中有13例(14.9%),水平为135-139mmol/L,在5例低钠血症中没有测量。显示低钠血症发生显着差异的患者特征包括体重,身体质量指数,肾功能,和预处理血清钠水平。定期监测血清钠对于早期发现低钠血症是必要的。
    结论:使用去氨加压素口腔崩解片治疗12周夜间多尿症时,低钠血症是最常见的不良反应。
    OBJECTIVE: This interim report presents the 12-week results of a post-marketing surveillance evaluating the safety of desmopressin orally disintegrating tablets 25 and 50 μg in Japanese men with nocturia due to nocturnal polyuria.
    METHODS: Of the planned study population of 1000 Japanese men receiving desmopressin for the first time for nocturia due to nocturnal polyuria, 971 cases were enrolled. In this interim analysis, 9 cases, including 6 registry violations and 3 cases of unconfirmed desmopressin dosing, were excluded from the 354 case report forms collected and fixed by the end of December 2021, and data up to 12 weeks after administration in 345 cases were defined as the safety analysis set.
    RESULTS: The mean age was 74.5 ± 9.9 years and 88.7% of the survey participants were aged ≥65 years. Desmopressin was started at a dose of 25 μg in 153 cases (44.3%). There were 102 adverse drug reactions (ADRs) reported in 71 cases, including 6 serious ADRs in 3 cases (0.9%). The most common ADR was hyponatremia occurring in 29 cases (8.4%). Eight of the hyponatremic cases were asymptomatic. Symptoms were resolved or slightly improved within 4 weeks of onset in 13 of 29 cases of hyponatremia. In addition, hyponatremia occurred in 11 of 217 cases (5.1%), with a serum sodium level before the administration of desmopressin of ≥140 mmol/L, and in 13 of 87 cases (14.9%), with a level of 135-139 mmol/L, and was not measured in 5 hyponatremia cases. Patient characteristics that showed significant differences in the occurrence of hyponatremia included body weight, body mass index, renal function, and pretreatment serum sodium level. Regular monitoring of serum sodium is necessary for early detection of hyponatremia.
    CONCLUSIONS: Hyponatremia was the most common ADR when desmopressin orally disintegrating tablets were used to treat nocturia due to nocturnal polyuria over a 12-week period.
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