Kim Kwi Suk, Choi Young Hee, Moon Aree, Kim Sang Geon
Department of Pharmacy, Seoul National University Hospital, Seoul 03080, Korea.
College of Pharmacy, Dongguk University Seoul, Goyang-si, Gyeonggi-do 10326, Korea.
J Clin Med. 2020 Feb 7;9(2):461. doi: 10.3390/jcm9020461.
Adalimumab is used at 40-mg dose to treat systemic inflammatory diseases. Given the impact of adverse drug reactions (ADRs), which particularly result in the discontinuation of adalimumab therapy in female patients, this study examined whether sex affects the frequency and type of ADRs induced by adalimumab. In this study, the prescription records and laboratory data of patients aged ≥19 years who had been admitted to the Seoul National University Hospital (SNUH) and prescribed adalimumab were analyzed using an electronic medical record database. The analysis revealed that female patients more frequently experienced adalimumab-induced ADRs compared with male patients (63.2% vs. 52.2%). The incidence of ADRs was significantly higher in female patients with ankylosing spondylitis or rheumatoid arthritis than in male patients with similar conditions (81.5% vs. 60.7% or 64.4% vs. 50.0%, respectively). The median body weight (BW) was lower in female patients than in male patients (54.0 vs. 66.0 kg). Moreover, the incidence of ADRs in patients with a BW of <54.0 kg (i.e., the median female BW) was higher than for those with a BW of ≥54.0 kg, in both males and females. Our results suggested that the predominance of ADRs induced by adalimumab in females was because of their relatively lower BW. This suggests the importance of BW as a determining factor in sex disparity of ADR occurrences.
阿达木单抗以40毫克的剂量用于治疗全身性炎症性疾病。鉴于药物不良反应(ADR)的影响,尤其是这些反应导致女性患者停用阿达木单抗治疗,本研究调查了性别是否会影响阿达木单抗诱发的ADR的频率和类型。在本研究中,利用电子病历数据库分析了首尔国立大学医院(SNUH)收治并开具阿达木单抗处方的≥19岁患者的处方记录和实验室数据。分析显示,与男性患者相比,女性患者更频繁地出现阿达木单抗诱发的ADR(63.2%对52.2%)。强直性脊柱炎或类风湿关节炎女性患者的ADR发生率显著高于患有类似疾病的男性患者(分别为81.5%对60.7%或64.4%对50.0%)。女性患者的中位体重(BW)低于男性患者(54.0对66.0千克)。此外,体重<54.0千克(即女性中位体重)的患者中,ADR发生率高于体重≥54.0千克的患者,无论男性还是女性。我们的结果表明,阿达木单抗诱发的ADR在女性中占主导地位是因为她们的体重相对较低。这表明体重作为ADR发生性别差异的一个决定因素的重要性。