Hong Dongsheng, Ni Jian, Shan Wenya, Li Lu, Hu Xi, Yang Hongyu, Zhao Qingwei, Zhang Xingguo
Department of Pharmacy, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China.
Key Laboratory for Drug Evaluation and Clinical Research of Zhejiang Province, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China.
Zhejiang Da Xue Xue Bao Yi Xue Ban. 2020 May 25;49(2):253-259. doi: 10.3785/j.issn.1008-9292.2020.03.07.
To establish a clinically applicable model of rapid identification of adverse drug reaction program (RiADP) for risk management and decision-making of clinical drug use.
Based on the theory of disproportion analysis, frequency method and Bayes method, a clinically applicable RiADP model in R language background was established, and the parameters of the model were interpreted by MedDRA coding. Based on the actual monitoring data of FDA, the model was validated by the assessing hepatotoxicity of lopinavir/ritonavir (LPV/r).
The established RiADP model included four parameters: standard value of adverse drug reaction signal information, empirical Bayesian geometric mean value, ratio of reporting ratio and number of adverse drug reaction cases. Through the application of R language parameter package "phViD", the model parameters could be output quickly. After being encoded by MedDRA, it was converted into clinical terms to form a clinical interpretation report of adverse drug reactions. In addition, the evaluation results of LPV/r hepatotoxicity by the model were matched with the results reported in latest literature, which also proved the reliability of the model results.
In this study, a rapid identification method of adverse reactions based on post marketing drug monitoring data was established in R language environment, which is capable of sending rapid warning of adverse reactions of target drugs in public health emergencies, and providing intuitive evidence for risk management and decision-making of clinical drugs.
建立一种临床适用的药物不良反应快速识别程序(RiADP)模型,用于临床用药风险管理和决策。
基于不成比例分析理论、频率法和贝叶斯方法,在R语言背景下建立临床适用的RiADP模型,并用MedDRA编码解释模型参数。基于美国食品药品监督管理局(FDA)的实际监测数据,通过评估洛匹那韦/利托那韦(LPV/r)的肝毒性对模型进行验证。
所建立的RiADP模型包括4个参数:药物不良反应信号信息标准值、经验贝叶斯几何均值、报告率比值和药物不良反应病例数。通过应用R语言参数包“phViD”,可快速输出模型参数。经MedDRA编码后,转化为临床术语,形成药物不良反应临床解读报告。此外,该模型对LPV/r肝毒性的评估结果与最新文献报道结果相符,也证明了模型结果的可靠性。
本研究在R语言环境下建立了一种基于上市后药品监测数据的不良反应快速识别方法,能够在突发公共卫生事件中对目标药品不良反应发出快速预警,为临床用药风险管理和决策提供直观依据。