Page 104 - 《中国药房》2023年11期
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·药物与临床·


          美泊利单抗相关不良事件信号的挖掘与分析
                                                                              Δ

                                           2 #
          陈耀鑫 ,伍绍星 ,李浩轩 ,许银姬 (1.广州中医药大学第二临床医学院,广州 510405;2.广东省中医院呼吸
                                   1
                 1*
                           2
          与危重症医学科,广州 510120)
          中图分类号  R969.3;R976      文献标志码  A      文章编号  1001-0408(2023)11-1374-05
          DOI  10.6039/j.issn.1001-0408.2023.11.17

          摘   要  目的  为临床合理使用美泊利单抗提供参考。方法  采用报告比值比法和贝叶斯可信区间递进神经网络法,对2016年第
          1季度至2022年第3季度美国FDA不良事件报告系统中有关美泊利单抗的药品不良事件(ADE)报告进行信号挖掘与分析。结
          果  共提取到以美泊利单抗为首要怀疑药物的 ADE 报告 57 501 份,涉及 16 358 例患者,其中男性所占比例(23.51%)低于女性
         (50.48%);报告国家以美国(51.91%)和加拿大(29.94%)为主;消费者(71.18%)是主要上报人群。挖掘出172个ADE阳性信号,主
          要涉及呼吸系统、胸及纵隔疾病(41.63%),感染及侵染类疾病(14.16%)等13个系统器官分类。共有60个高风险信号,其中15个
          为美泊利单抗药品说明书明确提及或相关的药品不良反应,45个(如哮喘危象、痰变色、脓痰、一般性疾病引起的睡眠障碍等)为
          新的高风险信号;各有11个高风险信号有性别差异或年龄差异。结论  临床应用美泊利单抗时,除药品说明书中提及的不良反应
          外,还应重点关注痰液性质的改变、痛性呼吸、睡眠障碍等。
          关键词  美泊利单抗;药品不良事件;信号挖掘;合理用药;药品不良反应


          Mining and analysis of adverse drug event signals related to mepolizumab
                                                  1
                                                            2
                       1
                                     2
          CHEN Yaoxin ,WU Shaoxing ,LI Haoxuan ,XU Yinji(1.  The  Second  Clinical  Medical  College,  Guangzhou
          University of Chinese Medicine, Guangzhou 510405, China;2. Dept. of Respiratory and Critical Care Medicine,
          Guangdong Provincial Hospital of Traditional Chinese Medicine, Guangzhou 510120, China)
          ABSTRACT    OBJECTIVE  To  provide  reference  for  rational  clinical  use  of  mepolizumab.  METHODS  The  reporting  odds  ratio
          method  and  Bayesian  confidence  propagation  neural  network  method  were  used  to  conduct  signal  mining  and  analysis  of  adverse
          drug  event (ADE)  reports  related  to  mepolizumab  in  the  United  States  Food  and  Drug  Administration  Adverse  Event  Reporting
          System  from  the  first  quarter  of  2016  to  the  third  quarter  of  2022.  RESULTS  A  total  of  57  501 ADE  reports  were  extracted  with
          mepolizumab as the primary suspect drug, involving 16 358 patients. Among these reports, the proportion of males (23.51%) was
          lower  than  females (50.48%).  The  reporting  countries  were  primarily  the  United  States (51.91%)  and  Canada (29.94%).
          Consumers (71.18%)  constituted  the  main  reporting  population.  A  total  of  172  ADE-positive  signals  were  identified,  mainly
          involving  13  system  organ  classes  such  as  the  respiratory,  thoracic  and  mediastinal  disorders (41.63%),  as  well  as  infectious  and
          parasitic  diseases (14.16%).  There  were  60  high-risk  signals,  including  15  that  were  explicitly  mentioned  or  related  to  adverse
          reactions  in  the  drug  instructions  of  mepolizumab  and  45  signals (such  as  asthmatic  crisis,  sputum  discoloured,  purulent  sputum,
          sleep  disorder  due  to  a  general  medical  condition)  were  newly  identified  high-risk  signals.  Among  them,  11  high-risk  signals
          exhibited  gender  or  age  differences.  CONCLUSIONS  When  clinically  using  mepolizumab,  in  addition  to  the  adverse  reactions
          mentioned  in  the  drug  instruction,  special  attention  should  also  be  given  to  changes  in  the  nature  of  sputum,  painful  respiration,
          and sleep disorders.
          KEYWORDS     mepolizumab; adverse drug events; signal mining; rational drug use; adverse drug reaction


              美泊利单抗源自中国仓鼠的卵巢细胞,是首个针对                          细胞表面受体的特异性亚基结合,从而减少嗜酸性粒细
                                                                              [1]
          白细胞介素5(interleukin-5,IL-5)的人源化单克隆抗体,                胞介导的炎症反应 。美泊利单抗在 2015 年年底被美
          可特异性地结合人体 IL-5,阻断 IL-5 的 α 链与嗜酸性粒                   国FDA批准用于治疗12岁及以上人群的重症嗜酸性粒
                                                                                                    [2]
                                                              细 胞 哮 喘(severe  eosinophilic  asthma,SEA) ,随 后 于
              Δ 基金项目 国家自然科学基金资助项目(No.82174313);广州市
                                                              2019 年 9 月将适用人群扩大至 6~11 岁儿童,且相继在
          校(院)联合资助项目基础与应用基础研究项目(No.202201020306)
                                                              全球多个国家用于治疗成人嗜酸性肉芽肿性多血管炎
             *第一作者 硕士研究生。研究方向:中西医结合治疗呼吸系统疾
          病。E-mail:20201120430@stu.gzucm.edu.cn              (eosinophilic granulomatosis with polyangiitis,EGPA)、高
              # 通信作者 主任医师,硕士生导师,硕士。研究方向:中西医结合                 嗜酸性粒细胞增多综合征(hypereosinophilic syndrome,
          治疗呼吸系统疾病。E-mail:xuyinji@163.com                     HES)、慢性鼻-鼻窦炎伴鼻息肉(chronic rhinosinusitis


          · 1374 ·    China Pharmacy  2023 Vol. 34  No. 11                            中国药房  2023年第34卷第11期
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