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铂类药物的不良事件特征:FDA 不良事件报告系统公共版本(AERS)的数据挖掘和临床观察的重现性。

Adverse event profiles of platinum agents: data mining of the public version of the FDA adverse event reporting system, AERS, and reproducibility of clinical observations.

机构信息

Center for Integrative Education in Pharmacy and Pharmaceutical Sciences, Graduate School of Pharmaceutical Sciences, Kyoto University, Kyoto 606-8501, Japan.

出版信息

Int J Med Sci. 2011;8(6):487-91. doi: 10.7150/ijms.8.487. Epub 2011 Aug 16.

Abstract

OBJECTIVE

Adverse event reports (AERs) submitted to the US Food and Drug Administration (FDA) were reviewed to confirm platinum agent-associated adverse events, and to clarify the rank-order of these drugs in terms of susceptibility.

METHODS

After a revision of arbitrary drug names and the deletion of duplicated submissions, AERs involving cisplatin (CDDP), carboplatin (CBDCA), or oxaliplatin (L-OHP) were analyzed. Authorized pharmacovigilance tools were used for the quantitative detection of signals, i.e., drug-associated adverse events, including the proportional reporting ratio, the reporting odds ratio, the information component given by a Bayesian confidence propagation neural network, and the empirical Bayes geometric mean.

RESULTS

Based on 1,644,220 AERs from 2004 to 2009, CDDP, CBDCA, and L-OHP all proved to cause nausea, vomiting, acute renal failure, neutropenia, thrombocytopenia, and peripheral sensory neuropathy. Higher susceptibility to nausea was found for CDDP than CBDCA and L-OHP. Acute renal failure was also more predominant for CDDP, and CBDCA did not increase the blood level of creatinine. A stronger association with thrombocytopenia was suggested for CBDCA. Susceptibility to peripheral sensory neuropathy was greatest for L-OHP, but less extensive for CDDP and CBDCA.

CONCLUSION

The results obtained herein were consistent with clinical observations, suggesting the usefulness of the FDA's adverse event reporting system, AERS, and the data mining method used herein.

摘要

目的

对美国食品和药物管理局(FDA)提交的不良事件报告(AER)进行审查,以确认铂类药物相关的不良事件,并阐明这些药物对不良事件的易感性的排序。

方法

对顺铂(CDDP)、卡铂(CBDCA)或奥沙利铂(L-OHP)的 AER 进行分析,对任意药物名称进行修订,并删除重复提交的内容。使用授权的药物警戒工具定量检测信号,即药物相关不良事件,包括比例报告比、报告比值比、贝叶斯置信传播神经网络给出的信息成分和经验贝叶斯几何均值。

结果

基于 2004 年至 2009 年的 1644220 份 AER,CDDP、CBDCA 和 L-OHP 均证明可引起恶心、呕吐、急性肾衰竭、中性粒细胞减少、血小板减少和周围感觉神经病。CDDP 引起恶心的易感性高于 CBDCA 和 L-OHP。CDDP 也更容易导致急性肾衰竭,而 CBDCA 不会增加血肌酐水平。CBDCA 与血小板减少的相关性更强。L-OHP 引起周围感觉神经病的易感性最大,但 CDDP 和 CBDCA 的范围较小。

结论

本研究结果与临床观察一致,表明 FDA 的不良事件报告系统(AERS)和本文使用的数据挖掘方法是有用的。

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