Banovac Marin, Candore Gianmario, Slattery Jim, Houÿez Francois, Haerry David, Genov Georgy, Arlett Peter
European Medicines Agency (EMA), 30 Churchill Place, Canary Wharf, London, E14 5EU, UK.
European Organisation for Rare Diseases (EURORDIS), Paris, France.
Drug Saf. 2017 Jul;40(7):629-645. doi: 10.1007/s40264-017-0534-1.
New pharmacovigilance legislation was adopted in the EU in 2010 and became operational in July 2012. The legislation placed an obligation on all national competent authorities (NCAs) and marketing authorisation holders (MAHs) to record and report cases of suspected adverse drug reactions (ADRs) received from patients.
This descriptive study aims to provide insight into patient reporting for the totality of the EU by querying the EudraVigilance (EV) database for the period of 3 years before the new pharmacovigilance legislation became operational and the 3 years after as well as comparing patient reports with those from healthcare professionals (HCPs) where feasible.
We queried the EV database for the following characteristics of patient and HCP reports: demographics (patient sex and age), seriousness, reported ADR terms, reported indications, number of ADRs per report, time to report an ADR, and most reported substances. Wherever feasible, direct comparisons between patient reports and HCP reports were performed using relative risks.
The EV database contained a total of 53,130 patient reports in the 3 years preceding the legislation operation period and 113,371 in the 3 years after. Member states contributing the most patient reports to the EV database were the Netherlands, the UK, Germany, France and Italy. The results for indications and substances show that patients were more likely than HCPs to report for genitourinary, hormonal and reproductive indications. Patients reported more in general disorders and administration site conditions Medical Dictionary for Regulatory Activities (MedDRA) System Organ Class (SOC), whereas HCPs reported more Preferred Terms (PTs) belonging in the Investigations SOC. However, 13 of the 20 reactions most frequently reported by patients were also among the top 20 reactions reported by HCPs.
Patient reporting complemented reporting by HCPs. Patients were motivated to report ADRs, especially those that affected their quality of life. Sharing these results with NCAs and patient associations can inform training and awareness on patient reporting.
欧盟于2010年通过了新的药物警戒法规,并于2012年7月开始实施。该法规要求所有国家主管当局(NCA)和上市许可持有人(MAH)记录并报告从患者处收到的疑似药物不良反应(ADR)病例。
本描述性研究旨在通过查询新药物警戒法规实施前3年和实施后3年的欧洲药物警戒数据库(EudraVigilance,EV),深入了解欧盟整体的患者报告情况,并在可行的情况下将患者报告与医疗保健专业人员(HCP)的报告进行比较。
我们查询了EV数据库中患者和HCP报告的以下特征:人口统计学信息(患者性别和年龄)、严重程度、报告的ADR术语、报告的适应症、每份报告的ADR数量、报告ADR的时间以及报告最多的物质。在可行的情况下,使用相对风险对患者报告和HCP报告进行直接比较。
在法规实施前3年,EV数据库共包含53130份患者报告,实施后3年为113371份。向EV数据库贡献患者报告最多的成员国是荷兰、英国、德国、法国和意大利。适应症和物质的结果表明,患者比HCP更有可能报告泌尿生殖、激素和生殖方面的适应症。患者在一般疾病和给药部位情况的医学法规活动医学词典(MedDRA)系统器官分类(SOC)中报告较多,而HCP在调查SOC中的首选术语(PT)报告较多。然而,患者最常报告的20种反应中有13种也在HCP报告的前20种反应之列。
患者报告补充了HCP的报告。患者有动力报告ADR,尤其是那些影响其生活质量的ADR。与NCA和患者协会分享这些结果可以为患者报告的培训和提高认识提供信息。