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止痛药不良反应报告:美国食品和药物管理局不良事件报告系统的数据挖掘。

Reported Adverse Events with Painkillers: Data Mining of the US Food and Drug Administration Adverse Events Reporting System.

机构信息

Department of Epidemiology, University of Florida, 2004 Mowry Rd, PO Box 100231, Gainesville, FL, 32610, USA.

出版信息

Drug Saf. 2018 Mar;41(3):313-320. doi: 10.1007/s40264-017-0611-5.

Abstract

INTRODUCTION

One-third of adults in the USA experience chronic pain and use a variety of painkillers, such as nonsteroidal anti-inflammatory drugs (NSAIDs), acetaminophen, and opioids. However, some serious adverse events (AEs), such as cardiovascular incidents, overdose, and death, have been found to be related to painkillers.

METHODS

We used 2015 and 2016 AE reports from the US FDA's Adverse Events Reporting System (FAERS) to conduct exploratory analysis on the demographics of those who reported painkiller-related AEs, examine the AEs most commonly associated with different types of painkillers, and identify potential safety signals. Summary descriptive statistics and proportional reporting ratios (PRRs) were performed.

RESULTS

Out of over 2 million reports submitted to FAERS in 2015 and 2016, a total of 64,354 AE reports were associated with painkillers. Reports of opioid-associated AEs were more likely to be from males or younger patients (mean age 47.6 years). The highest numbers of AEs were reported for NSAID and opioid use, and the most commonly found AEs were related to drug ineffectiveness, administration issues, abuse, and overdose. Death was reported in 20.0% of the reports, and serious adverse reactions, including death, were reported in 67.0%; both adverse outcomes were highest among patients using opioids or combinations of painkillers and were associated with PRRs of 2.12 and 1.87, respectively.

CONCLUSIONS

This study examined the AEs most commonly associated with varying classes of painkillers by mining the FAERS database. Our results and methods are relevant for future secondary analyses of big data and for understanding adverse outcomes related to painkillers.

摘要

简介

美国有三分之一的成年人患有慢性疼痛,并使用各种止痛药,如非甾体抗炎药(NSAIDs)、对乙酰氨基酚和阿片类药物。然而,一些严重的不良反应(AE),如心血管事件、过量用药和死亡,已被发现与止痛药有关。

方法

我们使用了美国 FDA 的不良事件报告系统(FAERS)在 2015 年和 2016 年的 AE 报告,对报告与止痛药相关的 AE 的人群的人口统计学特征进行了探索性分析,研究了与不同类型止痛药相关的最常见的 AE,并确定了潜在的安全信号。进行了总结性描述性统计和比例报告比值(PRR)。

结果

在 2015 年和 2016 年提交给 FAERS 的超过 200 万份报告中,共有 64354 份与止痛药相关的 AE 报告。阿片类药物相关 AE 报告更可能来自男性或年轻患者(平均年龄 47.6 岁)。AE 报告数量最多的是 NSAID 和阿片类药物使用,最常见的 AE 与药物无效、给药问题、滥用和过量有关。报告中有 20.0%的死亡病例,有 67.0%的报告有严重不良反应,包括死亡;这两种不良后果在使用阿片类药物或联合使用止痛药的患者中最高,分别与 PRR 为 2.12 和 1.87 相关。

结论

本研究通过挖掘 FAERS 数据库,检查了与不同类别的止痛药最常见相关的 AE。我们的结果和方法对于未来对大数据的二次分析以及了解与止痛药相关的不良后果具有重要意义。

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