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基于美国FAERS数据库挖掘与分析阿伐替尼ADE信号
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胡 颖 ,李建萍,唐 斌,丁 乔(遵义医科大学第三附属医院/遵义市第一人民医院神经重症医学科,贵州
*
#
遵义 563000)
中图分类号 R969.3;R979.1 文献标志码 A 文章编号 1001-0408(2023)13-1622-05
DOI 10.6039/j.issn.1001-0408.2023.13.15
摘 要 目的 为阿伐替尼的临床安全应用提供参考。方法 从美国FAERS数据库收集2020年1月9日至2022年9月30日关于
阿伐替尼的药品不良事件(ADE)报告,采用比例失衡法中的报告比值比法和比例报告比法进行数据挖掘与分析。结果 共收集到
以阿伐替尼为首要怀疑药物的ADE报告10 895份,排除无效信号后得到201个ADE信号,涉及19个系统器官分类。耳鸣、痴呆、
四肢厥冷、血铁减少、血糖下降、发热、维生素D下降、维生素B12下降等ADE,以及肌肉骨骼及结缔组织疾病、生殖系统及乳腺疾病
这2个SOC中的所有ADE均未被该药的药品说明书收载。用药信息完整的ADE报告有670份,以神经系统(230份,占34.33%)
和眼器官(277份,占41.34%)的ADE报告占比较大。与其他系统相比,日剂量和用药疗程对神经系统及眼器官ADE的影响显著
(P<0.05),患者年龄对神经系统ADE的影响显著(P<0.05)。结论 年龄≥65岁、日剂量300 mg/d、用药疗程31~90 d的患者使用
阿伐替尼后发生神经系统ADE的风险较高;而日剂量300 mg/d、用药疗程31~90 d的患者还容易发生眼器官ADE。临床在使用
阿伐替尼过程中,应重点关注患者眼部、神经系统方面的异常表现,并及时予以干预。
关键词 阿伐替尼;药品不良事件;比例失衡法;信号挖掘;药物不良反应
Mining and analysis of the ADE signals of avapritinib based on FAERS database
HU Ying,LI Jianping,TANG Bin,DING Qiao(Dept. of Neurology and Critical Care Medicine,the Third
Affiliated Hospital of Zunyi Medical University/Zunyi First People’s Hospital,Guizhou Zunyi 563000,China)
ABSTRACT OBJECTIVE To provide reference for clinically safe application of avapritinib. METHODS The adverse drug event
(ADE) reports of avapritinib from January 9th,2020,to September 30th,2022 were collected from FDA Adverse Event Reporting
System (FAERS) database. For data mining and analysis,reporting odds ratio (ROR) method and proportional reporting ratio
(PRR) method in the proportional imbalance method were utilized. RESULTS A total of 10 895 ADE reports with avapritinib as
the main suspect drug were gathered,and 201 ADE signals involving 19 systematic organ classifications were found after
eliminating invalid signals. The instruction of the drugs did not mention any of the ADE,including tinnitus,dementia,chilly limbs,
the reduction of blood iron,the reduction of blood sugar,fever,the reduction of vitamin D and vitamin B12,as well as all ADE in the
2 SOCs of musculoskeletal and connective tissue illnesses,diseases of the reproductive system,and diseases of the breast. The
majority of the ADE reports 670 cases with complete drug information were for the nervous system (230 cases,accounting for
34.33%) and ocular organ (277 cases,accounting for 41.34%). Compared with other systems,daily dose and treatment course
showed significant effects on ADE of neurological system and ocular organ (P<0.05),and the patient’s age had a significant
impact on the ADE of the nervous system (P<0.05). CONCLUSIONS A greater incidence of ADE after using avapritinib is
present in patients older than 65 with a daily dose of 300 mg/d and a treatment period lasting between 31 and 90 days; patients
receiving a daily dose of 300 mg/d and a treatment regimen lasting 31 to 90 days are more likely to experience ADE of the ocular
organ. Attention should be given to the aberrant symptoms of the patient’s eyes and nervous system throughout clinical use of
avapritinib,and prompt intervention should be given.
KEYWORDS avapritinib; adverse drug event; proportional imbalance method; signal mining; adverse drug reaction
胃肠道间质瘤(gastrointestinal stromal tumor,GIST)
Δ 基金项目 遵义市科技计划项目[No. 遵市科合 HZ 字(2021)- [1]
是一种罕见的肿瘤,占胃肠道恶性肿瘤的 1%~3% 。
256号]
据统计,全世界每年GIST的发病率为0.001%~0.002%,
*第一作者 主治医师,硕士。研究方向:神经外科重症医学、神经
循证医学、循证药学。电话:0851-28926446。E-mail:2742659187@qq. 多发于中老年患者,但在男女性中的发病率无明显差
com [2―3]
异 。临床数据表明,11%~47% 的 GIST 患者在首次
# 通信作者 副主任医师,博士。研究方向:神经外科重症医学、神
[4]
就诊时已发生转移,转移部位以肝脏和腹腔为主 。目
经循证医学、循证药学。电话:0851-28926446。E-mail:543010175@
qq.com 前,外科手术是局限性或潜在可切除 GIST 的首选治疗
· 1622 · China Pharmacy 2023 Vol. 34 No. 13 中国药房 2023年第34卷第13期