Huang Amy H, Kaffenberger Benjamin H, Reich Adam, Szepietowski Jacek C, Ständer Sonja, Kwatra Shawn G
Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, 21205 MD, USA.
Bloomberg School of Public Health, Johns Hopkins University, Baltimore, 21205 MD, USA.
Medicines (Basel). 2019 Aug 4;6(3):84. doi: 10.3390/medicines6030084.
Sparse data are available on rates of drug-induced pruritus, a well-recognized adverse reaction. We sought to assess relative rates of pruritus associated with commonly prescribed medications. Using the electronic medical record system EPIC, retrospective data were collected on patients seen at Johns Hopkins who received a medication of interest in a five-year period (2013-2018). Sequential criteria were used to identify the subpopulation who presented with a chief complaint of "pruritus" or diagnosis of "itching" within three months of receiving drugs. We identified 9802 patients with pruritus after drug initiation and 1,085,404 patients without. A higher proportion of those with pruritus were female (70%) than those without (58%), < 0.001. Patients in both groups were most commonly 50 to 79 years old. A higher proportion of patients with pruritus were black (40%) compared to those without (23%), < 0.001. In this study, the highest rates of pruritus were observed with heparin (1.11%), trimethoprim-sulfamethoxazole (1.06%), and calcium channel blockers (0.92%). Psychiatric/neurologic drugs used to treat pruritus were associated with low rates of itch. Certain cardiovascular and antimicrobial agents are associated with increased frequencies of pruritus. This knowledge may guide providers in clinical selection of commonly used agents to minimize adverse effects associated with reduced compliance.
关于药物性瘙痒这一公认的不良反应发生率的稀疏数据是可用的。我们试图评估与常用药物相关的瘙痒相对发生率。利用电子病历系统EPIC，收集了约翰·霍普金斯医院在五年期间（2013 - 2018年）接受感兴趣药物治疗的患者的回顾性数据。采用序贯标准来确定在接受药物治疗后三个月内以“瘙痒”为主诉或诊断为“瘙痒症”的亚组人群。我们确定了9802例药物引发瘙痒的患者和1085404例无瘙痒的患者。有瘙痒的患者中女性比例（70%）高于无瘙痒的患者（58%），P<0.001。两组患者最常见的年龄为50至79岁。有瘙痒的患者中黑人比例（40%）高于无瘙痒的患者（23%），P<0.001。在本研究中，肝素（1.11%）、甲氧苄啶 - 磺胺甲恶唑（1.06%）和钙通道阻滞剂（0.92%）引发瘙痒的发生率最高。用于治疗瘙痒的精神科/神经科药物引发瘙痒的发生率较低。某些心血管药物和抗菌药物与瘙痒频率增加有关。这些知识可能会指导临床医生在选择常用药物时尽量减少与依从性降低相关的不良反应。
