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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
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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