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与他汀类药物使用相关的肌萎缩侧索硬化症:FDA 不良事件报告系统的比例失调分析。

Amyotrophic Lateral Sclerosis Associated with Statin Use: A Disproportionality Analysis of the FDA's Adverse Event Reporting System.

机构信息

Department of Medicine, University of California, San Diego, 9500 Gilman Drive # 0995, La Jolla, CA, 92093-0995, USA.

Advera Health Analytics, Inc., Santa Rosa, CA, USA.

出版信息

Drug Saf. 2018 Apr;41(4):403-413. doi: 10.1007/s40264-017-0620-4.

DOI:10.1007/s40264-017-0620-4
PMID:29427042
Abstract

INTRODUCTION

Apparent elevations in reporting of amyotrophic lateral sclerosis (ALS)-like conditions associated with statin use have been previously described from data obtained via US and European databases.

OBJECTIVE

The aim of this study was to examine US FDA Adverse Event Reporting System (FAERS) data to compare reporting odds ratios (RORs) of ALS and ALS-like conditions between statins and other drugs, for each statin agent.

METHODS

We assessed for disproportional rates of reported ALS and ALS-related conditions for each statin agent separately by using the ROR formula. FAERS data were analyzed through September 2015.

RESULTS

RORs for ALS were elevated for all statins, with elevations possibly stronger for lipophilic statins. RORs ranged from 9.09 (6.57-12.6) and 16.2 (9.56-27.5) for rosuvastatin and pravastatin (hydrophilic) to 17.0 (14.1-20.4), 23.0 (18.3-29.1), and 107 (68.5-167) for atorvastatin, simvastatin, and lovastatin (lipophilic), respectively. For simvastatin, an ROR of 57.1 (39.5-82.7) was separately present for motor neuron disease.

CONCLUSION

These findings extend previous evidence showing that significantly elevated ALS reporting extends to individual statin agents, and add to concerns about potential elevated occurrence of ALS-like conditions in association with statin usage.

摘要

简介

先前曾有研究通过美国和欧洲的数据库获得的数据描述了与他汀类药物使用相关的肌萎缩侧索硬化症(ALS)样疾病报告率的明显升高。

目的

本研究旨在通过美国食品药品监督管理局不良事件报告系统(FAERS)数据比较每种他汀类药物的 ALS 和 ALS 样疾病的报告比值比(ROR),以评估他汀类药物与其他药物之间的差异。

方法

我们分别使用 ROR 公式评估每种他汀类药物单独报告的 ALS 和 ALS 相关疾病的比例是否失调。FAERS 数据的分析截至 2015 年 9 月。

结果

所有他汀类药物的 ALS 的 ROR 均升高,亲脂性他汀类药物的升高幅度可能更大。罗苏伐他汀和普伐他汀(亲水性)的 ROR 范围为 9.09(6.57-12.6)和 16.2(9.56-27.5),阿托伐他汀、辛伐他汀和洛伐他汀(亲脂性)的 ROR 分别为 17.0(14.1-20.4)、23.0(18.3-29.1)和 107(68.5-167)。对于辛伐他汀,运动神经元疾病的 ROR 分别为 57.1(39.5-82.7)。

结论

这些发现扩展了先前的证据,表明与他汀类药物使用相关的 ALS 报告率显著升高,这进一步增加了对与他汀类药物使用相关的 ALS 样疾病发生风险升高的担忧。

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