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戈沙妥珠单抗的药物不良事件信号挖掘与分析
                                                                                 Δ


          王艺璐 ,张 科,李正翔(天津医科大学总医院药剂科,天津 300052)
                *
                                 #
          中图分类号  R969.3      文献标志码  A      文章编号  1001-0408(2024)20-2527-06
          DOI  10.6039/j.issn.1001-0408.2024.20.15

          摘  要  目的  挖掘戈沙妥珠单抗的药物不良事件(ADE)信号,为其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)2020年4月1日至2024年4月30日上报的戈沙妥珠单抗ADE数据。采用报告比值比法、英国药品和保健品管理局
          综合标准法、贝叶斯置信度递进神经网络法进行数据挖掘。利用《国际医学用语词典》27.0 版 ADE 术语集中的系统器官分类
         (SOC)、首选术语(PT)进行分类统计。结果  共得到戈沙妥珠单抗ADE报告753份,包括46个ADE信号,涉及12个SOC、13个说
          明书中未记载的新的可疑的ADE信号。发生频次排名前5位的PT分别为疾病进展、死亡、腹泻、超说明书使用、产品给予时间表
          不当。信号强度排名前5位的PT分别为发热性骨髓再生障碍、中性粒细胞减少性结肠炎、疾病进展、肺脓毒症、一般身体状况异
          常。药品说明书未记录的新的可疑的ADE包括中性粒细胞减少性脓毒症、肝细胞溶解、脑膜炎、发育不全等。结论  临床使用戈
          沙妥珠单抗时,应特别关注发热性中性粒细胞减少症、发热性骨髓再生障碍、体重波动、结肠炎等报告例数多且信号强度高的
          ADE;还应警惕中性粒细胞减少性脓毒症、肝细胞溶解、脑膜炎、发育不全等新的可疑的ADE,以保障患者用药安全。
          关键词  戈沙妥珠单抗;药物不良事件;抗体-药物偶联物;数据挖掘

          Signal mining and analysis of adverse events of sacituzumab govitecan
          WANG Yilu,ZHANG Ke,LI Zhengxiang(Dept.  of  Pharmacy,  Tianjin  Medical  University  General  Hospital,
          Tianjin 300052, China)

          ABSTRACT   OBJECTIVE To mine the adverse drug event (ADE) signals of sacituzumab govitecan and provide a reference for

          its  clinical  safety  application.  METHODS  The  data  of  sacituzumab  govitecan-related  ADE  reports  were  collected  from  the  FDA
          Adverse  Event  Reporting  System (FAERS)  database  from  April  1,  2020  to  April  30,  2024.  The  reporting  odds  ratio(ROR)
          method, the United Kingdom Medicines and Healthcare Products Regulatory Agency comprehensive standard method (MHRA) and
          Bayesian  confidence  propagation  neural  network (BCPNN)  method  were  used  for  data  mining.  Systematic  organ  classification
         (SOC)  and  preferred  term (PT)  in  the ADE  terminology  set  of  version  27.0  of  the  Medical  Dictionary  for  Regulatory  Activities
         (MedDRA)  were  used  for  data  classification  and  statistics.  RESULTS  A  total  of  753 ADE  reports  were  obtained  for  sacituzumab
          govitecan, including 46 ADE signals, involving 12 SOCs, and 13 new suspicious ADE signals not recorded in the instructions. Top
          5  PTs  in  terms  of  occurrence  frequency  were  disease  progression,  death,  diarrhea,  off  label  use  and  inappropriate  schedule  of
          product  administration.  Top  5  PTs  in  terms  of  signal  strength  were  febrile  bone  marrow  aplasia,  neutropenic  colitis,  disease
          progression,  pulmonary  sepsis,  general  physical  condition  abnormal.  New  ADE  not  recorded  in  the  drug  instructions  included
          neutropenic  sepsis,  hepatic  cytolysis,  meningitis,  aplasia,  etc.  CONCLUSIONS  When  using  sacituzumab  govitecan  in  clinical
          practice,  special  attention  should  be  paid  to  ADE  with  highly  reported  cases  and  strong  signal  intensity,  such  as  febrile
          neutropenia,  febrile  bone  marrow  aplasia,  weight  fluctuations,  colitis.  We  should  also  be  alert  to  new  suspected  ADE  such  as
          neutropenic sepsis, hepatic cytolysis, meningitis, and aplasia to ensure patient medication safety.
          KEYWORDS    sacituzumab govitecan; adverse drug event; antibody-drug conjugate; data mining



              戈沙妥珠单抗是全球第一个上市的以人滋养层细                          胞表面抗原 2(human trophoblast cell surface antigen 2,
                                                             Trop-2)为靶点的抗体-药物偶联物(antibody-drug conju‐
             Δ 基金项目“白求恩·求索-药学科研能力建设”项目(No.B-19-H-
                                                                       [1]
          20200622)                                          gate,ADC) 。该药由靶向 Trop-2 的人源化单克隆抗
             *第一作者 主管药师,硕士。研究方向:医院药学。E-mail:                 体、可裂解的连接子、伊立替康的活性代谢产物 SN-38
          18322603264@163.com
                                                             组成,通过靶向结合肿瘤细胞表面表达的Trop-2,将 SN-
             #  通信作者 主 任 药 师 。 研 究 方 向 :医 院 药 学 。 电 话 :022-
          60363702。E-mail:13820893896@163.com                38运送至靶细胞中发挥细胞毒性作用,进而杀死肿瘤细


          中国药房  2024年第35卷第20期                                              China Pharmacy  2024 Vol. 35  No. 20    · 2527 ·
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