Wilton Lynda V, Shakir Saad
Drug Safety Research Unit, Southampton, England.
Epilepsia. 2002 Sep;43(9):983-92. doi: 10.1046/j.1528-1157.2002.01702.x.
Our aim was to monitor the use of gabapentin (GBP) by patients prescribed this drug by primary care physicians in England soon after it was marketed in the United Kingdom.
A noninterventional observational cohort study was conducted by using the technique of prescription-event monitoring. Patients were identified from dispensed National Health Service prescriptions. Outcome data were obtained from questionnaires sent to the doctor approximately 6 months after the initial prescription. These data included demographic information, events reported since starting GBP, and reason for stopping the drug, if it was stopped. Incidence rates were calculated for given periods for all events reported. Additional information was requested for selected events of medical interest, including pregnancies. Standardised mortality ratio (SMR) was calculated.
The cohort comprised 3,100 patients, of whom 136 (4%) were children. The median duration of treatment was 8.1 months. The most frequently reported adverse events reported during the first month of treatment, drowsiness/sedation, dizziness, and malaise/lassitude, also were the commonest reasons for discontinuing GBP and reported as suspected adverse drug reactions (ADRs). There were no congenital anomalies in the 11 babies born to women who used GBP during the first trimester of pregnancy. Crude mortality rate was 5 times that in general population but similar to that in other published studies.
Neurologic-related events were the most frequently reported adverse events. They also were the commonest reasons for discontinuing treatment and reported as suspected ADRs. No previously unrecognised adverse events were detected in this large cohort of patients who were among the first treated with gabapentin in England.
我们的目的是监测加巴喷丁(GBP)在英国上市后不久,由英国基层医疗医生开此药的患者对其的使用情况。
采用处方事件监测技术进行非干预性观察队列研究。从国民健康服务局配发的处方中识别出患者。结局数据是在首次处方后约6个月发送给医生的问卷中获得的。这些数据包括人口统计学信息、开始服用GBP后报告的事件,以及停药原因(如果停药的话)。计算了所有报告事件在特定时间段内的发病率。对于选定的具有医学意义的事件,包括妊娠,要求提供更多信息。计算了标准化死亡率(SMR)。
该队列包括3100名患者,其中136名(4%)为儿童。治疗的中位持续时间为8.1个月。治疗第一个月最常报告的不良事件,嗜睡/镇静、头晕和不适/乏力,也是停用GBP的最常见原因,并被报告为疑似药物不良反应(ADR)。在妊娠头三个月使用GBP的女性所生的11名婴儿中,没有先天性异常。粗死亡率是普通人群的5倍,但与其他已发表研究中的死亡率相似。
神经系统相关事件是最常报告的不良事件。它们也是停药的最常见原因,并被报告为疑似ADR。在英国首批接受加巴喷丁治疗的这一大群患者中,未检测到以前未被认识的不良事件。