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钆布醇用于老年患者的对比增强磁共振成像:来自临床试验、上市后监测和药物警戒数据的安全性概况综述。

Gadobutrol for contrast-enhanced magnetic resonance imaging in elderly patients: review of the safety profile from clinical trial, post-marketing surveillance, and pharmacovigilance data.

作者信息

Endrikat J, Schwenke C, Prince M R

机构信息

Department of Global Medical Affairs, Bayer HealthCare, Berlin, Germany; Saarland University Hospital, Homburg, Saar, Germany.

SCO:SSiS Statistical Consulting, Berlin, Germany.

出版信息

Clin Radiol. 2015 Jul;70(7):743-51. doi: 10.1016/j.crad.2015.03.011. Epub 2015 Apr 29.

DOI:10.1016/j.crad.2015.03.011
PMID:25933719
Abstract

AIM

To assess the safety of gadobutrol administration in elderly patients (≥65 years) by comparing the incidence of adverse drug reactions (ADRs) following gadobutrol-enhanced magnetic resonance imaging (MRI) procedures in elderly patients with that in adults aged 18-64 years.

MATERIALS AND METHODS

Safety data on gadobutrol administration from clinical trials, post-marketing surveillance (PMS) studies, and pharmacovigilance reports were collected in three databases. In each dataset, absolute and relative frequencies of ADRs between age groups were analysed, along with odds ratios and 95% confidence intervals. Logistic regression was used to identify significant influencing factors on ADRs in the PMS and pharmacovigilance data.

RESULTS

Rates of reported ADRs were lower in elderly patients versus adults aged <65 years due to a reduced incidence of non-serious ADRs; this was statistically significant for the clinical trials and pharmacovigilance populations, with a trend in the PMS database. Serious ADRs occurred infrequently in the clinical trials and PMS populations (too low for statistical comparison), and pharmacovigilance data demonstrated a low incidence (<0.005%) in both age groups.

CONCLUSIONS

This evaluation involving three large databases demonstrated no greater incidence of ADRs following gadobutrol-enhanced MRI in elderly patients (≥65 years) compared with younger adults, with gadobutrol having a favourable safety profile in both age groups.

摘要

目的

通过比较老年患者(≥65岁)与18 - 64岁成年人在钆布醇增强磁共振成像(MRI)检查后药物不良反应(ADR)的发生率,评估钆布醇在老年患者中的用药安全性。

材料与方法

从三个数据库收集了来自临床试验、上市后监测(PMS)研究及药物警戒报告中有关钆布醇用药的安全性数据。在每个数据集中,分析了各年龄组ADR的绝对和相对频率,以及比值比和95%置信区间。采用逻辑回归分析PMS和药物警戒数据中ADR的显著影响因素。

结果

由于非严重ADR的发生率降低,老年患者报告的ADR发生率低于<65岁的成年人;这在临床试验和药物警戒人群中具有统计学意义,在PMS数据库中也有此趋势。严重ADR在临床试验和PMS人群中发生率较低(因发生率过低无法进行统计学比较),药物警戒数据显示两个年龄组的发生率均较低(<0.005%)。

结论

这项涉及三个大型数据库的评估表明,与年轻成年人相比,老年患者(≥65岁)在钆布醇增强MRI检查后ADR的发生率并未更高,钆布醇在两个年龄组中均具有良好的安全性。

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