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·药物与临床·


          基于FAERS数据库的利那洛肽风险信号挖掘
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          张 科 ,李 波 ,宋 崟 ,孙 璇 ,邵 佳 ,李正翔 (1.天津医科大学总医院药剂科,天津 300052;2.天津
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          市第一中心医院药学部,天津 300192)
          中图分类号  R969.3;R975      文献标志码  A      文章编号  1001-0408(2022)22-2758-04
          DOI  10.6039/j.issn.1001-0408.2022.22.14
          摘   要  目的  挖掘利那洛肽的风险信号,为该药的临床安全使用提供参考。方法  使用OpenVigil 2.1数据平台,获取美国FDA
          不良事件报告系统(FAERS)数据库中2012年8月30日-2021年12月31日的利那洛肽相关不良事件(ADE)报告数据。采用比例
          失衡法中的报告比值比(ROR)法和比例报告比值(PRR)法进行数据挖掘,利用《国际医学用语词典》(23.1版)中药物不良反应术
          语集的首选系统器官分类(SOC)和首选术语(PT)对挖掘到的风险信号进行分类和描述。结果  共检索到利那洛肽相关ADE报告
          17 590 份,其中严重的 ADE 报告有 5 494 份(占 31.23%)。共检测到相关风险信号 120 个。按发生频次排序,前 10 位的风险信号
         (以PT表示)依次是腹泻、药物无效、超说明书用药、腹胀、腹痛、给药时间不当、上腹痛、胃肠胀气、产品存储错误、故意误用产品;
          按信号强度排序,双氢睾酮增加(ROR值为271.258,PRR值为271.131)位列首位,双氢睾酮增加和椎间盘压迫这2个信号均未被
          药品说明书收录。2种排序方式所得风险信号的SOC以各类检查、胃肠系统疾病、全身性疾病及给药部位各种反应等为主。结
          论  应用利那洛肽时,除药品说明书中提及的不良反应外,临床还须密切关注其药品说明书未提及的安全风险(如双氢睾酮增加和
          椎间盘压迫),以保证患者的用药安全。
          关键词  利那洛肽;美国FDA不良事件报告系统;风险信号;报告比值比法;比例报告比值法

          Data mining of risk signals for linaclotide based on FAERS database
          ZHANG Ke ,LI Bo ,SONG Yin ,SUN Xuan ,SHAO Jia ,LI Zhengxiang(1.  Dept.  of  Pharmacy,  Tianjin
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          Medical  University  General  Hospital,  Tianjin  300052,  China;2.  Dept.  of  Pharmacy,  Tianjin  First  Central
          Hospital, Tianjin 300192, China)
          ABSTRACT    OBJECTIVE  To  mine  the  risk  signals  of  linaclotide,  so  as  to  provide  evidence  for  clinically  safe  drug  use.
          METHODS  OpenVigil 2.1  data platform was  used  to  obtain the  adverse  drug  event (ADE)  report  data of  linaclotide  from August
          30, 2012 to December 31, 2021 in the database of FDA adverse event reporting system (FAERS). The reporting odds ratio (ROR)
          and  proportional  report  ratio (PRR)  of  the  proportional  imbalance  method  were  used  to  mine  the  data  of ADE  reports. The  mined
          risk signals were statistically classified and described by the preferred system organ class (SOC) and preferred term (PT) stated in
          the  Medical  Dictionary  for  Regulatory Activities (23.1  edition).  RESULTS  There  were  17  590 ADE  reports  related  to  linaclotide,
          including  5  494  reports  of  severe ADE,  accounting  for  about  31.23%. A  total  of  120  risk  signals  were  detected. According  to  the
          frequency  of  occurrence,  top  10  risk  signals (measured  by  PT)  were  diarrhea,  ineffective  drugs,  off-label  drug  use,  abdominal
          distension, abdominal pain, improper administration time, epigastric pain, flatulence, product storage error and intentional misuse
          of  products. According  to  the  signal  intensity,  the  increase  of  dihydrotestosterone (ROR  was  271.258,  PRR  was  271.131)  ranked
          the first, and two signals such as the increase of dihydrotestosterone and the compression of intervertebral disc were not mentioned
          in  the  drug  instructions.  The  SOC  of  risk  signals  obtained  by  two  sorting  methods  mainly  included  various  examinations,
          gastrointestinal diseases, systemic diseases and various reactions at the administration site. CONCLUSIONS  In clinical application
          of linaclotide, in addition to the adverse drug reactions mentioned in the drug instructions, close attention should be paid to safety
          risks  such  as  increase  of  dihydrotestosterone  and  the  compression  of  intervertebral  disc,  which  are  not  mentioned  in  the
          instructions, so as to guarantee the safety of drug use.
          KEYWORDS     linaclotide; FDA adverse event reporting system; risk signal; reporting odds ratio; proportional report ratio



              Δ 基金项目 天津市科技计划项目(No.20JCQNJC01810)                  便秘型肠易激综合征(irritable bowel syndrome with
             *第一作者 主管药师,硕士。研究方向:医院药学。E-mail:                  constipation,IBS-C)是一种易发于中老年人的消化道疾
          Zhangke06045114@163.com
              #  通信作者 主 任 药 师 。 研 究 方 向 :医 院 药 学 。 电 话 :022-  病,主要临床症状为便秘,并伴有腹痛、腹胀或腹部不适
          60363702。E-mail:13820893896@163.com                 等症状,严重影响患者的正常工作和生活                  [1―2] 。利那洛


          · 2758 ·    China Pharmacy  2022 Vol. 33  No. 22                            中国药房  2022年第33卷第22期
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