Regional pharmacovigilance center, department of pharmacology, Pitié-Salpêtrière hospital, 47/83, boulevard de l'Hôpital, 75013 Paris, France.
Regional pharmacovigilance center, department of pharmacology, Pitié-Salpêtrière hospital, 47/83, boulevard de l'Hôpital, 75013 Paris, France.
Therapie. 2020 Nov-Dec;75(6):591-598. doi: 10.1016/j.therap.2020.02.022. Epub 2020 Feb 26.
Over the past decades, assessment of drug safety and of their benefits harms balance has been profoundly modified by the availability of large databases and computerized automated statistical approaches. Improvement of digital data storage capacity has been applied to pharmacovigilance reports. VigiBase, the international pharmacovigilance database, is now aggregating over 21 million individual case safety reports in 2020. Identification and investigation of drug safety signals - concerning notably rare and unknown adverse drug reactions - is one of the major tasks in pharmacovigilance that can be amplified by automated signal detection. Several quantitative statistical methods exist, each with its own strengths and limits. Integrating signal detection, pharmacovigilance databases can be used for a wide variety of retrospective observational studies illustrated here by concrete examples. Confirming these signals by orthogonal validation using pre-clinical platforms and prospective trials is helpful. Pharmacovigilance databases represent a considerable source of information. However, the quality of signal detection and of pharmacoepidemiology studies in the field of adverse drug reaction closely depends on the quality of the individual data recorded.
在过去几十年中,通过大型数据库和计算机化自动化统计方法的可用性,药物安全性及其益处危害平衡的评估发生了深刻的变化。数字数据存储容量的提高已应用于药物警戒报告。VigiBase,国际药物警戒数据库,目前正在汇总 2020 年超过 2100 万份个体病例安全报告。药物警戒的主要任务之一是识别和调查药物安全性信号 - 特别是罕见和未知的药物不良反应 - 可以通过自动化信号检测来放大。有几种定量统计方法,每种方法都有其自身的优势和局限性。通过整合信号检测,药物警戒数据库可用于广泛的回顾性观察性研究,这里通过具体示例进行说明。使用临床前平台和前瞻性试验进行正交验证来确认这些信号是有帮助的。药物警戒数据库代表了相当大的信息来源。然而,药物不良反应领域信号检测和药物流行病学研究的质量在很大程度上取决于记录的单个数据的质量。