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吉瑞替尼的不良事件信号挖掘与分析
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          刘 洋 ,韩敏珍,夏 杰,胡涵帅,姚 磊,兰 雪,刘 倩,王晋星一(贵州医科大学第二附属医院药剂科,贵
                *
                                                                         #
          州 凯里 556000)

          中图分类号  R979.1      文献标志码  A      文章编号  1001-0408(2024)15-1888-05
          DOI  10.6039/j.issn.1001-0408.2024.15.15

          摘   要  目的  挖掘吉瑞替尼的不良事件(ADE)信号,为临床安全用药提供参考。方法  收集美国 FDA 不良事件报告系统
         (FAERS)2018年2月1日至2023年12月31日上报的以吉瑞替尼为首要怀疑药物的ADE报告,采用报告比值比(ROR)法和比例
          报告比值比(PRR)法进行数据挖掘。利用《国际医学用语词典》(24.1 版)药物 ADE 术语集中的首选术语(PT)和系统器官分类
         (SOC)进行分类统计。结果  共得到吉瑞替尼ADE报告2 755份,包含676个ADE信号(阳性ADE信号95个),累及313个PT,涉
          及25个SOC。其中,有9个ADE信号未被其药品说明书提及。信号强度排名前5位的PT分别为肝功能异常、血小板计数降低、发
          热性中性粒细胞减少症、肺炎和骨髓抑制;阳性信号数排名前6位的SOC分别为各类检查,全身性疾病及给药部位各种反应,呼吸
          系统、胸及纵隔疾病,感染及侵染类疾病,心脏器官疾病,各类神经系统疾病。其药品说明书未提及的ADE包括肺炎、骨髓抑制、
          血细胞减少症、败血症、出血、感染(未特指)、感染性休克、呼吸衰竭、曲霉菌感染。结论  应用吉瑞替尼时,临床除需关注肝功能异
          常、血小板减少症等常见ADE外,还应监测药品说明书未提及且信号较强的ADE,如肺炎、骨髓抑制、血细胞减少症、败血症、出
          血、感染(未特指)、感染性休克、呼吸衰竭、曲霉菌感染、血肌酐升高及间质性肺疾病等。
          关键词  吉瑞替尼;药品不良事件;药物警戒;数据挖掘


          Signal mining and analysis of adverse drug events for gilteritinib
          LIU Yang,HAN Minzhen,XIA Jie,HU Hanshuai,YAO Lei,LAN Xue,LIU Qian,WANG Jinxingyi(Dept.  of
          Pharmacy, the Second Affiliated Hospital of Guizhou Medical University, Guizhou Kaili 556000, China)

          ABSTRACT    OBJECTIVE To mine the adverse drug events (ADE) signals for gilteritinib, and provide a reference for safe drug
          use in clinic. METHODS ADE reports with gilteritinib as the primary suspected drug were extracted from the FDA Adverse Event
          Reporting  System (FAERS)  database  from  February  1st,  2018  to  December  31st,  2023.  Reporting  odds  ratio (ROR)  and
          proportional  reporting  ratio (PRR)  were  applied  to  detect  the  risk  signals  from  the  data  in  the  FAERS  database. The  classification
          and  statistics  of  collected  signal  data  were  conducted  by  using  the  preferred  term (PT)  and  systemic  organ  class (SOC)  in ADE
          terminology  set  of  the  Medical  Dictionary  for  Regulatory  Activities (24.1  edition).  RESULTS  Totally,  2  755  gilteritinib-related
          ADE  reports  were  collected  from  the  database,  involving  676 ADE  signals (95  positive  signals),  313  PTs  and  25  SOCs. Among
          them, nine signals were not recorded in the package insert. The top 5 PTs consisted of abnormal liver function, decreased platelet
          count,  febrile  neutropenia,  pneumonia  and  myelosuppression.  The  top  6  SOCs  for  positive  signal  counts  were  examinations,
          general  disorders  and  administration  site  conditions,  respiratory,  thoracic  and  mediastinal  disorders,  infections  and  infestations,
          heart  organ  disorders,  and  nervous  system  disorders.  ADEs  not  recorded  in  the  drug  package  insert  included  pneumonia,
          myelosuppression,  decreased  blood  cell  count,  sepsis,  hemorrhage,  infection (not  specifically  referred  to),  septic  shock,
          respiratory  failure,  and  aspergillosis.  CONCLUSIONS  In  addition  to  paying  attention  to  common ADEs  such  as  liver  dysfunction
          and  thrombocytopenia,  it  is  necessary  to  monitor ADEs  with  strong  signals  that  are  not  mentioned  in  the  drug  instructions  when
          using  gefitinib,  such  as  pneumonia,  bone  marrow  suppression,  cytopenia,  sepsis,  bleeding,  infection (not  specifically  referred
          to), septic shock, respiratory failure, Aspergillus infection, elevated serum creatinine and interstitial lung disease.
          KEYWORDS     gilteritinib; adverse drug events; pharmacovigilance; data mining



              Δ 基金项目 贵州省科技计划项目(No. 黔科合基础-ZK〔2022〕一                急性髓系白血病(acute myeloid leukemia,AML)是
          般410);贵州省卫生健康委科学技术基金项目(No.gzwkj2021-508)            一种髓系造血干细胞克隆异常导致的大量异常分化的
             *第一作者 副主任药师。研究方向:医院药学、临床药学。电话:
                                                              髓系细胞在骨髓内聚集而产生的恶性肿瘤。AML患者
          0855-3833088。E-mail:284510826@qq.com
                                                              生存期短、预后较差。AML在成人中高发,且发病率可
              # 通信作者 副主任药师,硕士生导师,硕士。研究方向:医院药
          学、临床药学。电话:0855-3833013。E-mail:245505880@qq.com      随年龄的增加而升高,老年(>60岁)患者的5年生存率


          · 1888 ·    China Pharmacy  2024 Vol. 35  No. 15                            中国药房  2024年第35卷第15期
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