Veyrac G, Paulin M, Milpied B, Bourin M, Jolliet P
Centre Régional de Pharmacovigilance, Institut de Biologie, Nantes.
Therapie. 2002 Jan-Feb;57(1):55-64.
A French nation-wide pharmacovigilance survey of ketoprofen topic collated, from September 1996 to August 2000, 770 cutaneous side-effects. The frequency varies from 0.013@1000 to 0.028@1000 according to the commercial gel. Analysis concerns spontaneous notifications of French nation-wide pharmacovigilance. Sex ratio is well distributed, population is young. Treatment lasted about 12 days, the side-effects appearing after about 13 days, 25 per cent of cases are delayed to discontinuance of treatment, mainly after exposure to sunlight. Co-administered drugs are in most cases systemic or topical NSAIDs and/or fibrates and then increase the seriousness of the iatrogenic pathology. 75 per cent of cutaneous side-effects appear in summer, 50 per cent have been reported as "photosensitivity". Reactions are severe in 30 per cent of the cases. More than 80 per cent of cases present an extension beyond the site of application. The course is usually favourable and neither topical nor systemic corticosteroid treatment influence the duration of evolution. Photopatchtests testing in 23 per cent of cases show evidence of photoallergy to ketoprofen and crossed photoallergy with tiaprofenic acid, fenofibrate, oxybenzone and benzophenone. These results confirm that photoallergy is due to the common benzoylketone structure but not to their arylpropionic function. Some cases of persistent or recurrent photosensitivity must be more explored. The results lead to request a modification of marketing authorizations.
1996年9月至2000年8月,法国开展了一项全国性的酮洛芬局部用药药物警戒调查,共整理出770例皮肤副作用报告。根据不同的商用凝胶制剂,其发生率在0.013/1000至0.028/1000之间。分析基于法国全国药物警戒的自发报告。性别比例分布均匀,患者群体以年轻人为主。治疗持续约12天,副作用约在13天后出现,25%的病例在停药后才出现副作用,主要是在暴露于阳光后。在大多数情况下,同时使用的药物为全身性或局部性非甾体抗炎药和/或贝特类药物,这会加重医源性病理状况的严重性。75%的皮肤副作用出现在夏季,50%的病例报告为“光敏性”。30%的病例反应严重。超过80%的病例皮疹范围超出用药部位。病程通常良好,局部或全身性皮质类固醇治疗均不影响病程持续时间。23%的病例进行光斑贴试验显示对酮洛芬存在光过敏反应,并与噻洛芬酸、非诺贝特、氧苯酮和二苯甲酮存在交叉光过敏反应。这些结果证实光过敏是由常见的苯甲酰酮结构引起,而非其芳基丙酸功能。一些持续性或复发性光敏性病例仍需进一步研究。这些结果促使要求修改上市许可。