Løkken P, Skomedal T
Farmakologisk institutt, Universitetet i Oslo.
Tidsskr Nor Laegeforen. 1992 Jun 10;112(15):1978-80.
Sales statistics indicate that the number of Norwegians treated with calcium channel blockers increased from about 50,000 in 1986 to about 83,000 in 1991 (last year: nifedipine 39%, verapamil 27%, amlodipine 21%, diltiazem 10% and felodipine 3%). In spite of widespread use, only one report on gingival hyperplasia induced by calcium channel blockers has been received by the Norwegian Adverse drug reaction committee. The incidence of this adverse reaction is uncertain, but the few controlled studies that have been performed indicate that it may be as high as 15% in patients on long-term treatment, at least with nifedipine. This corresponds to nearly 5,000 cases among the about 32,000 users of nifedipine. Norwegian physicians and dentists are asked to report cases of gingival hyperplasia induced by calcium channel blockers. Although the voluntary report system is fraught with uncertainty, it is hoped that, in a relatively small and surveyable drug market as the Norwegian, the reporting may provide some relevant information, e.g. to allow comparison of the potential of the various calcium channel blockers to induce this adverse effect. A Norwegian controlled study on gingival conditions among long-term users of calcium channel blockers is in its initial stage. It may be of interest to compare the results of this study with the indications obtained from the spontaneous reporting on the incidence of this adverse effect, which is relatively easy to diagnose.
销售统计数据表明,接受钙通道阻滞剂治疗的挪威人数量从1986年的约5万增加到了1991年的约8.3万(去年:硝苯地平占39%,维拉帕米占27%,氨氯地平占21%,地尔硫䓬占10%,非洛地平占3%)。尽管钙通道阻滞剂被广泛使用,但挪威药物不良反应委员会仅收到一份关于其引起牙龈增生的报告。这种不良反应的发生率尚不确定,但已进行的少数对照研究表明,长期接受治疗的患者中,至少使用硝苯地平的患者,其发生率可能高达15%。这相当于约3.2万硝苯地平使用者中近5000例病例。挪威的医生和牙医被要求报告钙通道阻滞剂引起的牙龈增生病例。尽管自愿报告系统充满不确定性,但希望在挪威这样一个相对较小且可进行调查的药物市场中,报告能提供一些相关信息,例如以便比较各种钙通道阻滞剂诱发这种不良反应的可能性。一项关于长期使用钙通道阻滞剂患者牙龈状况的挪威对照研究正处于初始阶段。将该研究结果与从这种相对容易诊断的不良反应发生率的自发报告中获得的指征进行比较,可能会很有意思。