Chen Shiqi, Kwong Joey S W, Zheng Rui, Wang Yanping, Shang Hongcai
Key Laboratory of Chinese Medicine of Ministry of Education and Beijing, Dongzhimen Hospital Affiliated to Beijing University of Chinese Medicine, Beijing 100700, China.
Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong.
Evid Based Complement Alternat Med. 2018 Nov 15;2018:4013912. doi: 10.1155/2018/4013912. eCollection 2018.
To summarize the characteristics and the relevant factors and to give references for preventing adverse drug reactions (ADRs) associated with xiyanping (XYP), we provide a systematic review of adverse case reports about XYP.
Seven medical databases were searched from inception to January 2018. Case reports detailing ADRs associated with XYP were included. Data were extracted independently by two reviewers. After the assessment of causality and severity, we carried out a descriptive analysis for the relevant ADRs.
Forty-three articles involving a total number of 55 cases were included. Eight cases were off-label drug use. In the remaining 47 cases, 26 (55.3%) had probable causality and 23 (48.9%) were serious cases. XYP used in children (≤14 years old) accounted for 66.0%. Respiratory diseases (83.0%) were major primary diseases. No allergic history mentioned (55.3%) and unspecific drug combination (59.6%) were common in these reports. As for ADR types, anaphylaxis and anaphylactic shock were up to 97.9%. ADRs happened mostly when applying XYP within 30 minutes (70.2%) and the majority (95.7%) were cured when treated in time.
Clinicians and patients are supposed to obey the package insert of XYP in clinical application. Through the results of XYP, normalization of ADR reports is also worthy of attention. High-quality researches are required to improve the drug instruction and evaluate the safety of XYP in effective diseases and different age groups. Mechanism of ADRs aiming at the hypersensitivity and the drug combination should still be further identified.
为总结喜炎平(XYP)相关不良反应(ADR)的特点、相关因素,为预防其ADR提供参考,我们对XYP的不良反应病例报告进行了系统评价。
检索了7个医学数据库,检索时间从建库至2018年1月。纳入详细描述与XYP相关ADR的病例报告。由两名研究者独立提取数据。在评估因果关系和严重程度后,我们对相关ADR进行了描述性分析。
纳入43篇文章,共55例病例。8例为超说明书用药。在其余47例中,26例(55.3%)因果关系可能,23例(48.9%)为严重病例。14岁及以下儿童使用XYP的占66.0%。呼吸系统疾病(83.0%)是主要的原发疾病。这些报告中常见未提及过敏史(55.3%)和非特异性药物联合使用(59.6%)。至于ADR类型,过敏反应和过敏性休克高达97.9%。ADR大多在应用XYP后30分钟内发生(70.2%),多数(95.7%)经及时治疗后治愈。
临床医生和患者在临床应用中应遵循XYP的药品说明书。通过XYP的研究结果,ADR报告的规范化也值得关注。需要高质量的研究来完善药品说明书,并评估XYP在有效疾病和不同年龄组中的安全性。针对过敏反应和药物联合使用的ADR机制仍需进一步明确。