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二肽基肽酶-4抑制剂的不良事件概况:美国食品药品监督管理局不良事件报告系统公开版本的数据挖掘

Adverse event profiles of dipeptidyl peptidase-4 inhibitors: data mining of the public version of the FDA adverse event reporting system.

作者信息

Huang Jing, Jia Yuntao, Sun Shusen, Meng Long

机构信息

Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China.

Department of Pharmacy, Ministry of Education Key Laboratory of Child Development and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing Key Laboratory of Pediatrics, Children's Hospital of Chongqing Medical University, Chongqing, China.

出版信息

BMC Pharmacol Toxicol. 2020 Sep 16;21(1):68. doi: 10.1186/s40360-020-00447-w.

Abstract

BACKGROUND

To describe and analyze the patterns of adverse events associated with dipeptidyl peptidase-4 inhibitors (DPP-4is) (sitagliptin, saxagliptin, linagliptin, vildagliptin, and alogliptin) from the FDA Adverse Event Reporting System (FAERS) and to highlight areas of safety concerns.

METHODS

Adverse events spontaneously submitted to the FAERS between 2004 Q1 to 2019 Q2 were included. The online tool OpenVigil 2.1 was used to query the database. The research relied on definitions of preferred terms (PTs) specified by the Medical Dictionary for Regulatory Activities (MedDRA) and the standardized MedDRA Queries (SMQ). The reporting odds ratio (ROR), with 95% confidence intervals (CIs) was calculated for disproportionality analysis.

RESULTS

Over 16 years, a total of 9706 adverse event reports were identified. Alogliptin was excluded from further analysis due to insufficient sample size. Compared with the non-insulin antidiabetic drugs, the four DPP-4is were all disproportionately associated with four SMQs: "gastrointestinal nonspecific inflammation and dysfunctional conditions," "hypersensitivity," "severe cutaneous adverse reactions," and "noninfectious diarrhoea". As for PT level analyses, DPP-4is are associated with higher reporting of the gastrointestinal tract, pancreas, malignancies, infection, musculoskeletal disorders, general disorders, hypersensitivity, and skin AEs.

CONCLUSIONS

Data mining of the FAERS is useful for examining DPP-4 inhibitors-associated adverse events. The findings of the present study are compatible with clinical experience, and it provides valuable information to decision-makers and healthcare providers in clinical practice.

摘要

背景

描述并分析美国食品药品监督管理局不良事件报告系统(FAERS)中与二肽基肽酶-4抑制剂(DPP-4i)(西他列汀、沙格列汀、利格列汀、维格列汀和阿格列汀)相关的不良事件模式,并突出安全关注领域。

方法

纳入2004年第一季度至2019年第二季度自发提交至FAERS的不良事件。使用在线工具OpenVigil 2.1查询数据库。该研究依赖于《监管活动医学词典》(MedDRA)指定的首选术语(PT)定义和标准化MedDRA查询(SMQ)。计算报告比值比(ROR)及95%置信区间(CI)用于不成比例分析。

结果

在16年期间,共识别出9706份不良事件报告。由于样本量不足,阿格列汀被排除在进一步分析之外。与非胰岛素类抗糖尿病药物相比,四种DPP-4i均与四个SMQ不成比例相关:“胃肠道非特异性炎症和功能障碍性疾病”、“超敏反应”、“严重皮肤不良反应”和“非感染性腹泻”。至于PT水平分析,DPP-4i与胃肠道、胰腺、恶性肿瘤、感染、肌肉骨骼疾病、全身性疾病、超敏反应和皮肤不良事件的更高报告相关。

结论

FAERS的数据挖掘有助于检查与DPP-4抑制剂相关的不良事件。本研究结果与临床经验相符,并为临床实践中的决策者和医疗服务提供者提供了有价值的信息。

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