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他汀类药物在儿童和青少年中的药物不良反应:来自世卫组织全球个体病例安全报告数据库的描述性分析。

Adverse drug reactions of statins in children and adolescents: a descriptive analysis from VigiBase, the WHO global database of individual case safety reports.

机构信息

Faculté de Médecine, Laboratoire de Pharmacologie Médicale et Clinique, F-31000, Toulouse, France.

Service de Pharmacologie Médicale et Clinique, Centre de Pharmacovigilance, de Pharmacoépidémiologie et d'Informations sur le Médicament, CHU, F-31000, Toulouse, France.

出版信息

Fundam Clin Pharmacol. 2020 Aug;34(4):518-520. doi: 10.1111/fcp.12542. Epub 2020 Mar 10.

Abstract

In adults, statins safety profile is well known. However, literature data on their adverse drug reactions (ADRs) remain scarce in children in real-life setting. In order to better characterize ADRs related to 'real-life' use of statins in children, we reviewed statin-related ADRs recorded in the World Health Organization (WHO) global database of individual case safety reports (ICSRs), VigiBase. Methods. Individual case safety reports (ICSRs) in children (2-11 years) and adolescents (12-17 years) associated with statins from January 1, 1987, to July 18, 2017, were extracted from VigiBase. Characteristics of ICSRs, type of ADRs according to MedDRA classification (SOC and PT), and ICSR seriousness were described using SAS 9.4. A total of 311 ICSRs were identified for 8 statins with 712 ADRs. Musculoskeletal disorders (n = 85, 27.3%) were the first registered ADRs followed by general disorders (n = 67, 21.5%; mainly asthenia and pain). More than 1 out of 5 ADRs were 'injury, poisoning and procedural complications' (n = 67), mainly accidental or intentional exposures (n = 44, 14.1%), overdoses (n = 14, 4.5%), or off-label use (n = 11, 3.5%). Overall, 133 (42.8%) reports were 'serious', including 11 deaths. Deaths mainly involved adolescents with intentional overdose and completed suicide with other associated drugs in 75% of reports. Our study identified rare but serious safety issues (rhabdomyolysis, myalgia, and hepatocellular injury). These ADRs can impact quality of life or lead to life-threatening complications in children. Our results should be supplemented with other data sources. Spontaneous statin ADR reports in children to pharmacovigilance networks must be promoted.

摘要

在成年人中,他汀类药物的安全性特征众所周知。然而,在现实生活环境中,关于儿童使用他汀类药物的不良反应(ADR)的文献数据仍然很少。为了更好地描述与儿童实际使用他汀类药物相关的 ADR,我们审查了世界卫生组织(WHO)个体病例安全报告(ICSR)全球数据库(VigiBase)中记录的他汀类药物相关 ADR。方法:从 1987 年 1 月 1 日至 2017 年 7 月 18 日,从 VigiBase 中提取与他汀类药物相关的 2-11 岁儿童和 12-17 岁青少年的个体病例安全报告(ICSR)。使用 SAS 9.4 描述 ICSR 的特征、根据 MedDRA 分类(SOC 和 PT)的 ADR 类型以及 ICSR 的严重程度。共确定了 311 例与 8 种他汀类药物相关的 ICSR,共 712 例 ADR。肌肉骨骼疾病(n=85,27.3%)是首次登记的 ADR,其次是一般疾病(n=67,21.5%;主要为乏力和疼痛)。超过 1/5 的 ADR 为“损伤、中毒和程序并发症”(n=67),主要为意外或故意暴露(n=44,14.1%)、用药过量(n=14,4.5%)或标签外使用(n=11,3.5%)。总体而言,133 份(42.8%)报告为“严重”,包括 11 例死亡。死亡主要涉及青少年,其中 75%的报告涉及故意用药过量和自杀,同时服用其他相关药物。我们的研究发现了罕见但严重的安全问题(横纹肌溶解症、肌痛和肝细胞损伤)。这些 ADR 可能会影响儿童的生活质量或导致危及生命的并发症。我们的结果应补充其他数据源。必须促进向药物警戒网络报告儿童他汀类药物 ADR。

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