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在韩国医院环境中,体重作为固定剂量阿达木单抗注射诱导女性患者药物不良反应优势的决定因素。

Body Weight as a Determining Factor in the Predominance of Adverse Drug Reactions Induced by Fixed-Dose Adalimumab Injections in Female Patients in a Korean Hospital Setting.

作者信息

Kim Kwi Suk, Choi Young Hee, Moon Aree, Kim Sang Geon

机构信息

Department of Pharmacy, Seoul National University Hospital, Seoul 03080, Korea.

College of Pharmacy, Dongguk University Seoul, Goyang-si, Gyeonggi-do 10326, Korea.

出版信息

J Clin Med. 2020 Feb 7;9(2):461. doi: 10.3390/jcm9020461.

DOI:10.3390/jcm9020461
PMID:32046138
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7074186/
Abstract

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.

摘要

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。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/eaf3/7074186/0a0298e8ff40/jcm-09-00461-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/eaf3/7074186/98bede19424d/jcm-09-00461-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/eaf3/7074186/0a0298e8ff40/jcm-09-00461-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/eaf3/7074186/98bede19424d/jcm-09-00461-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/eaf3/7074186/0a0298e8ff40/jcm-09-00461-g002.jpg

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本文引用的文献

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Adv Ther. 2020 Jan;37(1):364-380. doi: 10.1007/s12325-019-01145-8. Epub 2019 Nov 20.
2
Biosimilars of adalimumab: the upcoming challenge in IBD.阿达木单抗生物类似药:IBD 领域即将面临的挑战。
Expert Opin Biol Ther. 2019 Oct;19(10):1023-1030. doi: 10.1080/14712598.2019.1564033. Epub 2019 Jan 8.
3
Drug survival of biologics in treating psoriasis: a meta-analysis of real-world evidence.
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Sci Rep. 2018 Oct 30;8(1):16068. doi: 10.1038/s41598-018-34293-y.
4
Gender Differences in Axial Spondyloarthritis: Women Are Not So Lucky.性别差异与中轴型脊柱关节炎:女性并非如此“幸运”。
Curr Rheumatol Rep. 2018 May 12;20(6):35. doi: 10.1007/s11926-018-0744-2.
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Clinical Benefit of Long-Term Adalimumab Treatment in Patients With Crohn's Disease Following Loss of Response or Intolerance to Infliximab: 96-Week Efficacy Data From GAIN/ADHERE Trials.阿达木单抗治疗英夫利昔单抗治疗应答不佳或不耐受的克罗恩病患者的长期临床获益:GAIN/ADHERE 试验的 96 周疗效数据。
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