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左炔诺孕酮的安全性概况:对美国食品药品监督管理局不良事件报告系统(FAERS)数据库的不成比例性分析

Safety Profile of Levonorgestrel: A Disproportionality Analysis of Food and Drug Administration Adverse Event Reporting System (Faers) Database.

作者信息

Kurian Anitha, Kaushik Kanika, Subeesh Viswam, Maheswari Eswaran, Kunnavil Radhika

机构信息

Department of Pharmacy Practice, Faculty of Pharmacy, M.S. Ramaiah University of Applied Sciences, Bangalore, India.

Department of Community Medicine, M.S. Ramaiah Medical College, Bangalore, India.

出版信息

J Reprod Infertil. 2018 Jul-Sep;19(3):152-156.

Abstract

BACKGROUND

Levonorgestrel is most commonly utilized as an emergency oral contraceptive. Little is known and/or studied about the adverse effects of levonorgestrel, therefore, current investigation was aimed to generate signal for unreported adverse drug reactions of levonorgestrel using disproportionality analysis in food and drug administration adverse events reporting system database.

METHODS

In FDA Adverse Events Reporting System (FAERS) database, all adverse event reports for levonorgestrel between January 2006 to June 2015 were identified and disproportionality analysis was conducted for selected adverse events of levonorgestrel using Reporting Odds Ratio, Proportional Reporting Ratio and Information Component with 95% confidence interval.

RESULTS

A disproportionality analysis was done for 15 adverse events of levonorgestrel; out of these, signal for 10 adverse events was found and among them menstruation delayed was reported maximum (1791), followed by pregnancy after post-coital contraception (942), breast tenderness (901), metrorrhagia (899), dysmenorrhea (822), menorrhagia (541), nipple disorder (141), breast enlargement (77), ectopic pregnancy (61) and premenstrual syndrome (35). Pregnancy after post-coital contraception showed the highest signal having the Information Component value of 129.2, Reporting Odds Ratio value of 6.51 and Proportional Reporting Ratio value of 6.49.

CONCLUSION

In this paper, ten novel AEs were identified that were disproportionately reported with the use of LNG by using data mining techniques. Although a causal relationship cannot be established, the number of cases reported suggests that there might be an association. If confirmed by epidemiologic studies, the findings from this study would have potential implications for the use of LNG and patient management in clinical practice.

摘要

背景

左炔诺孕酮最常被用作紧急口服避孕药。关于左炔诺孕酮的不良反应,人们了解和/或研究得很少,因此,当前的调查旨在利用食品药品监督管理局不良事件报告系统数据库中的不成比例分析,来发现左炔诺孕酮未报告的药物不良反应信号。

方法

在食品药品监督管理局不良事件报告系统(FAERS)数据库中,识别出2006年1月至2015年6月期间所有关于左炔诺孕酮的不良事件报告,并使用报告比值比、比例报告比值和信息成分以及95%置信区间,对左炔诺孕酮选定的不良事件进行不成比例分析。

结果

对左炔诺孕酮的15种不良事件进行了不成比例分析;其中,发现了10种不良事件的信号,其中月经推迟报告最多(1791例),其次是性交后避孕失败后怀孕(942例)、乳房压痛(901例)、子宫出血(899例)、痛经(822例)、月经过多(541例)、乳头疾病(141例)、乳房增大(77例)、异位妊娠(61例)和经前综合征(35例)。性交后避孕失败后怀孕的信号最强,其信息成分值为129.2,报告比值比值为6.51,比例报告比值为6.49。

结论

在本文中,通过数据挖掘技术识别出了10种新的不良事件,这些事件在使用左炔诺孕酮时报告比例过高。虽然无法建立因果关系,但报告的病例数表明可能存在关联。如果经流行病学研究证实,本研究结果将对左炔诺孕酮在临床实践中的使用和患者管理具有潜在意义。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4dbf/6104423/689df3808744/JRI-19-152-g001.jpg

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