Severance Regional Pharmacovigilance Center, Seoul, Korea.
J Korean Med Sci. 2012 Mar;27(3):268-73. doi: 10.3346/jkms.2012.27.3.268. Epub 2012 Feb 23.
Hepatic adverse drug reactions (ADRs) to certain drugs may differ within each country, reflecting different patterns of prescription, socioeconomic status, and culture. The purpose of this study was to assess the suspected cause of hepatic ADRs using the spontaneously reported pharmacovigilance data from Korea. A total of 9,360 spontaneously reported adverse drug events (ADEs) from nine Pharmacovigilance Centers were analyzed. Risk of hepatic ADEs was assessed by calculating the reporting odds ratio (ROR). Of the 9,360 cases, 567 hepatic ADEs were reported. The most frequently prescribed drug classes inducing hepatic ADEs were anti-tuberculotics, cephalosporins, valproic acids, penicillins, quinolones, non-steroidal anti-inflammatory drugs (NSAIDs), anti-viral agents, and statins. ROR values were especially high in anti-tuberculosis drugs, systemic antifungal drugs for systemic use, anti-epileptics, propylthiouracil, and herbal medicines. Underlying diseases such as tuberculosis (6.9% vs 0.9%), pneumonia (4.9% vs 1.7%), intracranial injury including skull fracture (4.5% vs 0.9%), HIV (3.4% vs 0.4%), subarachnoid hemorrhage (2.8% vs 0.5%), and osteoporosis (2.4% vs 1.4%) were significantly more common in hepatic ADE group. In conclusion, anti-infective drugs, anti-epileptics, NSAIDs and statins are the most common suspects of the spontaneously reported hepatic ADEs, in Korea. Careful monitoring for such reactions is needed for the prescription of these drugs.
某些药物的肝不良反应(ADR)在不同国家可能存在差异,这反映了不同的处方模式、社会经济地位和文化。本研究的目的是使用韩国自发报告的药物警戒数据评估肝 ADR 的可疑原因。对来自九个药物警戒中心的 9360 例自发报告的不良药物事件(ADE)进行了分析。通过计算报告比值比(ROR)评估肝 ADE 的风险。在 9360 例病例中,报告了 567 例肝 ADE。最常引起肝 ADE 的药物类别为抗结核药、头孢菌素类、丙戊酸、青霉素类、喹诺酮类、非甾体抗炎药(NSAIDs)、抗病毒药物和他汀类药物。抗结核药、全身用系统性抗真菌药、抗癫痫药、丙硫氧嘧啶和草药的 ROR 值特别高。肺结核(6.9% vs 0.9%)、肺炎(4.9% vs 1.7%)、包括颅骨骨折的颅内损伤(4.5% vs 0.9%)、HIV(3.4% vs 0.4%)、蛛网膜下腔出血(2.8% vs 0.5%)和骨质疏松症(2.4% vs 1.4%)等基础疾病在肝 ADE 组中明显更为常见。总之,在韩国,抗感染药物、抗癫痫药、NSAIDs 和他汀类药物是自发报告肝 ADR 的最常见可疑药物。在开具这些药物时需要密切监测这些不良反应。