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替尔泊肽不良事件信号挖掘与分析
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          谢泽宇 ,梁焯茹 ,郑桂梅 ,曹伟灵 ,陈吉生 (1.深圳市罗湖区人民医院药学部,广东 深圳 518000;2.广东
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          药科大学附属第一医院国家临床药学重点专科,广州 510080)
          中图分类号  R969.3;R587      文献标志码  A      文章编号  1001-0408(2025)08-0956-05
          DOI  10.6039/j.issn.1001-0408.2025.08.11

          摘   要  目的  基于FDA不良事件报告系统(FAERS)数据库,对替尔泊肽相关药物不良事件(ADE)信号进行挖掘分析,为临床安
          全用药提供参考。方法  通过FAERS数据库提取2022年5月1日至2024年6月30日替尔泊肽为首要怀疑药物的ADE报告,并利
          用《国际医学用语词典》对筛选后的ADE的系统器官分类(SOC)和首选术语进行系统归纳,再通过报告比值比法和比例报告比值
          法对上述ADE 进行信号挖掘及分析。结果  共获得替尔泊肽相关ADE 报告39 229份,严重ADE 报告3 934份(10.03%),严重的
          ADE 报告以导致住院/住院时间延长为主(3.82%),涉及 131 个 ADE 阳性信号;已报告患者性别和患者年龄的 ADE 报告中,女性
          26 195份(66.77%),男性7 869份(20.06%),年龄以18~64岁为主(54.26%)。发生频次排名前3位的ADE分别为注射部位疼痛、
          恶心和注射部位出血。信号较强且并未被替尔泊肽说明书提及的ADE分别为注射部位发凉、饥饿性酮症酸中毒、注射部位出血、
          饥饿、肾上腺素升高、注射部位皮肤开裂、贪食、皮肤松解、肠脓毒症、饱腹感缺乏和痛觉异常。患者性别和年龄亚组分析结果表
          明,不同性别和年龄段患者的ADE报告数在不同SOC下所占比例存在差异,男性或≥65岁患者在胃肠系统疾病的风险大于女性
          或<65岁患者。结论  临床应用替尔泊肽时,除了关注药品说明书中记载的ADE外,还应关注注射部位发凉、饥饿性酮症酸中毒、
          注射部位出血、肾上腺素升高、肠脓毒症等药品说明书未提及的ADE,以保障患者安全用药。
          关键词  替尔泊肽;FDA不良事件报告系统;药物不良事件;信号挖掘

          Signal mining and analysis of adverse drug events of tirzepatide
          XIE Zeyu ,LIANG Zhuoru ,ZHENG Guimei ,CAO Weiling ,CHEN Jisheng(1.  Dept.  of  Pharmacy,  Shenzhen
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          Luohu  People’s  Hospital,  Guangdong  Shenzhen  518000,  China;2.  Key  Specialty  of  Clinical  Pharmacy,  the
          First Affiliated Hospital of Guangdong Pharmaceutical University, Guangzhou 510080, China)
          ABSTRACT    OBJECTIVE  To  identify  and  analyze  adverse  drug  event (ADE)  signals  associated  with  tirzepatide  based  on  the
          FDA Adverse  Event  Reporting  System (FAERS)  database,  providing  a  reference  for  clinical  medication  safety.  METHODS  ADE
          reports from January 1, 2022, to June 30, 2024, with tirzepatide as the primary suspected drug, were extracted from the FAERS
          database. Medical Dictionary for Regulatory Activities was used to systematically categorize the selected system organ class (SOC)
          and preferred term of ADE. Signal mining and analysis were performed using the reporting odds ratio method and the proportional
          reporting ratio method. RESULTS A total of 39 229 ADE reports related to tirzepatide were obtained, including 3 934 severe ADE
          reports (10.03%).  The  majority  of  severe  ADE  reports  were  related  to  hospitalization  or  prolonged  hospitalization (3.82%),
          involving  131  positive ADE  signals. Among  the  reports  with  documented  patient  gender  and  age,  26  195  were  female (66.77%),
          7 869 were male (20.06%), and the majority of patients were aged 18-64 years (54.26%). The top three most frequently reported
          ADE  were  injection  site  pain,  nausea,  and  injection  site  hemorrhage.  Strong  ADE  signals  not  mentioned  in  the  tirzepatide
          instruction  included  injection  site  coldness,  starvation  ketoacidosis,  injection  site  hemorrhage,  hunger,  elevated  adrenaline,
          injection  site  skin  cracking,  binge  eating,  skin  laxity,  intestinal  sepsis,  lack  of  satiety,  and  dysesthesia.  Subgroup  analysis  for
          patient’s  gender  and  age  showed  differences  in  the  proportion  of ADE  reports  across  different  SOC.  Male  patients  or  those  aged≥65
          years had a higher risk of gastrointestinal system disorders compared to female patients or those aged <65 years. CONCLUSIONS
          In  clinical  use  of  tirzepatide,  in  addition  to  monitoring  ADE  listed  in  the  instruction,  attention  should  also  be  paid  to  ADE  not
          mentioned  in  the  instruction,  such  as  injection  site  coldness,  starvation  ketoacidosis,  injection  site  hemorrhage,  elevated
          adrenaline, and intestinal sepsis, to ensure patient safety.
          KEYWORDS     tirzepatide; FDA Adverse Event Reporting System; adverse drug event; signal mining


              Δ 基金项目 中央财政医疗服务与保障能力提升补助资金项目
         (No. Z155080000004);深 圳 市 医 疗 卫 生 三 名 工 程 项 目(No.        2型糖尿病约占全球糖尿病的98%,研究显示,中国
          SZSM202301035)                                      20~79 岁成人糖尿病患病率由 1990 年的 4.7% 上升到
             * 第一作者 药 师 ,硕 士 。 研 究 方 向 :临 床 药 学 。 E-mail:
                                                              2019 年的 8.0%,增长了 70.2%;与 2019 年相比,预计
          578365488@qq.com
                                                              2020-2030 年,中国 20~79 岁成年人的糖尿病患病率
              # 通信作者 主任药师。研究方向:临床药学、药事管理。E-mail:
                                                                                 [1]
          cjslym@163.com                                      将从 8.0% 上升到 9.7% 。替尔泊肽注射液是一种可激

          · 956 ·    China Pharmacy  2025 Vol. 36  No. 8                               中国药房  2025年第36卷第8期
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