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他汀类药物使用与睡眠障碍的关联:对自发报告数据库和处方数据库的数据挖掘

Association of statin use with sleep disturbances: data mining of a spontaneous reporting database and a prescription database.

作者信息

Takada Mitsutaka, Fujimoto Mai, Yamazaki Kohei, Takamoto Masashi, Hosomi Kouichi

机构信息

Division of Clinical Drug Informatics, School of Pharmacy, Kinki University, 3-4-1, Kowakae, Higashi-osaka, Osaka, 577-8502, Japan,

出版信息

Drug Saf. 2014 Jun;37(6):421-31. doi: 10.1007/s40264-014-0163-x.

Abstract

BACKGROUND

Particular interest has been generated regarding the possible influence of statin use on sleep quality. However, no conclusive evidence exists that a particular statin is more likely to be associated with sleep disturbances versus others. It remains uncertain whether different statins produce different risks for sleep disturbance.

OBJECTIVE

To examine the association between statin use and the risk of sleep disturbances, we conducted data mining using the US Food and Drug Administration Adverse Event Reporting System (FAERS) and a large organized database of prescriptions constructed by a database vendor (Japan Medical Information Research Institute, Inc. Japan).

METHODS

Relevant reports in the FAERS were identified and analyzed. Data from the first quarter of 2004 through the end of 2012 [corrected] were included in this study.The reporting odds ratio (ROR) was used to detect spontaneous report signals, calculated using the case/non-case method. For the ROR, a signal was detected if the lower limit of 95 % two-sided confidence interval (95 % CI) was >1. Additionally, signal detection using the IC was conducted using the IC025 metric, a lower limit of the 95 % CI of the IC, where a signal is detected if the IC025 value exceeds 0. In addition, symmetry analysis was used to identify the risk of insomnia after using statins over the period of January 2006 to August 2013.

RESULTS

In the analyses of the FAERS database, significant signals for sleep disturbances including disturbances in initiating and maintaining sleep, sleep disorders NEC, sleeping disorders due to a general medical condition, and parasomnias were found. In the prescription sequence symmetry analysis, a significant association between statin use and hypnotic drug use was found, with adjusted sequence ratios of 1.14 (1.03-1.26), 1.20 (1.11-1.29), and 1.18 (1.11-1.25) at intervals of 91, 182, and 365 days, respectively.

CONCLUSION

Multi-methodological approaches using different algorithms and databases strongly suggest that statin use is associated with an increased risk for sleep disturbances including insomnia.

摘要

背景

他汀类药物的使用对睡眠质量可能产生的影响已引发了特别关注。然而,尚无确凿证据表明某一种他汀类药物比其他药物更易与睡眠障碍相关联。不同他汀类药物是否会产生不同的睡眠障碍风险仍不确定。

目的

为了研究他汀类药物的使用与睡眠障碍风险之间的关联,我们使用美国食品药品监督管理局不良事件报告系统(FAERS)以及由一家数据库供应商(日本医疗信息研究所,日本)构建的大型处方有组织数据库进行了数据挖掘。

方法

对FAERS中的相关报告进行识别和分析。本研究纳入了2004年第一季度至2012年底[已校正]的数据。报告比值比(ROR)用于检测自发报告信号,采用病例/非病例法计算。对于ROR,如果95%双侧置信区间(95%CI)的下限>1,则检测到信号。此外,使用IC025指标进行基于IC的信号检测,即IC的95%CI的下限,如果IC025值超过0,则检测到信号。另外,采用对称性分析来确定2006年1月至2013年8月期间使用他汀类药物后出现失眠的风险。

结果

在对FAERS数据库的分析中,发现了包括入睡和维持睡眠障碍、未另行分类的睡眠障碍、由一般医疗状况导致的睡眠障碍以及异态睡眠等睡眠障碍的显著信号。在处方序列对称性分析中,发现他汀类药物的使用与催眠药物的使用之间存在显著关联,在91天、182天和365天的时间间隔内,调整后的序列比值分别为1.14(1.03 - 1.26)、1.20(1.11 - 1.29)和1.18(1.11 - 1.25)。

结论

使用不同算法和数据库的多方法学方法有力地表明,他汀类药物的使用与包括失眠在内的睡眠障碍风险增加有关。

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