Page 93 - 《中国药房》2024年5期
P. 93

基于美国FAERS数据库的阿可替尼ADE信号挖掘与分析
                                                                                                  Δ


                                                           1 #
                                           3
                                   1
                          2
                                                   3
          熊 瑞 ,雷 静 ,张世鹏 ,张 宏 ,仝永涛 ,来小丹 (1.中国人民解放军陆军第九五八医院药剂科,重庆
                 1*
          400020;2.陆军特色医学中心药剂科,重庆 400042;3.中国人民解放军陆军第九五六医院药剂科,西藏 林芝
          860100)
          中图分类号  R969.3;R979.1      文献标志码  A      文章编号  1001-0408(2024)05-0595-06
          DOI  10.6039/j.issn.1001-0408.2024.05.15

          摘  要  目的  挖掘和分析阿可替尼的药物不良事件(ADE)信号,为其临床安全应用提供参考。方法  通过OpenVigil 2.1平台提
          取美国FDA不良事件报告系统数据库中2017年11月1日至2023年3月31日与阿可替尼相关的ADE报告,采用报告比值比法与
          英国药品和健康产品管理局综合标准法对ADE信号进行检测。结果  提取到以阿可替尼为首要怀疑药物的报告7 869份,从中检
          测到142个ADE阳性信号,涉及20个系统器官分类,基本与其药品说明书记载的ADE一致,主要涉及全身性疾病及给药部位各种
          反应、各类检查、血液及淋巴系统疾病、各类神经系统疾病和心脏器官疾病等。此外,还发现了一些未在其药品说明书中提及的新
          的潜在ADE信号,包括心源性猝死、肺毒性、肿瘤溶解综合征、胸腔积液、消化不良、胃食管反流病、骨痛、血压降低、血钠异常等。
          结论  在应用阿可替尼时,除了需要关注其说明书已记载的ADE外,还应评估其包括心源性猝死、肺毒性等可能导致死亡的严重
          ADE风险,尽可能避免或减少ADE的发生。
          关键词  阿可替尼;药物不良事件;数据挖掘;FDA不良事件报告系统;套细胞淋巴瘤

          Mining  and  analysis  of  acalabrutinib-induced  ADE  risk  signals  based  on  FDA  adverse  event  reporting
          system
                                                                                 3
          XIONG Rui ,LEI Jing ,ZHANG Shipeng ,ZHANG Hong ,TONG Yongtao ,LAI Xiaodan (1.  Dept.  of
                                                                                                1
                     1
                               2
                                                 1
                                                                 3
          Pharmacy,  the  958th  Hospital  of  Chinese  PLA,  Chongqing  400020,  China;2.  Dept.  of  Pharmacy,  Army
          Medical Center of PLA, Chongqing 400042, China;3. Dept. of Pharmacy, the 956th Hospital of Chinese PLA,
          Xizang Nyingchi 860100, China)
          ABSTRACT   OBJECTIVE  To  provide  reference  for  the  clinically  safe  application  of  acalabrutinib  by  mining  and  analyzing  the
          risk signals of adverse drug events (ADE). METHODS The acalabrutinib-induced ADE reports were extracted from the U.S. FDA
          adverse  event  reporting  system  using  the  OpenVigil  2.1  platform  from  November  1,  2017  to  March  31,  2023. The  reporting  odds
          ratio (ROR) method and composite criteria method from the Medicines and Healthcare Products Regulatory Agency (MHRA) were
          used for detection of ADE signals. RESULTS There were 7 869 ADE reports of acalabrutinib as the primary suspect drug and 142
          ADE  positive  signals  were  detected  from  them,  involving  20  system  organ  classes,  which  was  generally  consistent  with  the ADE
          recorded  in  the  drug  instruction  of  acalabrutinib,  mainly  involving  general  disorders  and  administration  site  conditions,  various
          inspection,  blood  and  lymphatic  system  disorders,  various  neurological  disorders  and  cardiac  disorders.  In  addition,  this  study
          identified  several  new  potential  ADE  signals  that  were  not  mentioned  in  the  drug  instruction,  including  sudden  cardiac  death,
          pulmonary  toxicity,  tumor  lysis  syndrome,  pleural  effusion,  dyspepsia,  gastroesophageal  reflux  disease,  bone  pain,  decreased
          blood pressure, and abnormal blood sodium, etc. CONCLUSIONS When using acalabrutinib, in addition to paying attention to the
          ADE  recorded  in  its  instructions,  the  risk  of  serious  ADE  that  may  lead  to  death,  such  as  sudden  cardiac  death  and  pulmonary
          toxicity, should also be evaluated to avoid or reduce the occurrence of ADE as much as possible.
          KEYWORDS    acalabrutinib; adverse drug event; data mining; FDA adverse event reporting system; mantle cell lymphoma



                                                                 套细胞淋巴瘤(mantle cell lymphoma,MCL)是一种
             Δ 基金项目 重庆市自然科学基金面上项目(No.CSTB2023NSCQ-           罕见且无法治愈的非霍奇金淋巴瘤亚型,占所有淋巴
          MSX0627);重庆市科卫联合医学科研项目(No.2022MSXM187)             瘤的 5%~7%,西方国家每年的发病率为 1/100 000~
             *第一作者 主管药师,硕士。研究方向:中药药理学、循证药学。                                                    [1]
                                                             2/100 000,亚洲国家的发病率相对较低 。MCL患者的
          E-mail:rxiong2017@sina.com
                                                                                                    [2]
                                                             中位年龄为 60~70 岁,约 70% 的病例为男性 。80% 以
             # 通信作者 主管药师,硕士。研究方向:临床药学、药事管理学。
          电话:023-68762086。E-mail:laixiaodan0926@sina.com     上的MCL患者确诊时已为晚期(Ann Arbor Ⅲ~Ⅳ期),

          中国药房  2024年第35卷第5期                                                 China Pharmacy  2024 Vol. 35  No. 5    · 595 ·
   88   89   90   91   92   93   94   95   96   97   98