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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
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