Lisbona-Alquézar María Pilar, Lanuza-Giménez Javier, Navarro-Pemán María Cristina, Esteban-Jiménez Óscar, Fernández-Alquézar Óscar, Fernández-Liesa Rafael
Servicio de Otorrinolaringología. Hospital Royo Villanova. Zaragoza. España.
Departamento de Farmacología y Fisiología. Facultad de Medicina. Universidad de Zaragoza. Zaragoza. España.
Rev Esp Salud Publica. 2020 Dec 9;94:e202012154.
One of the adverse drug reactions (ADR) can be the Ototoxicity, either in a cochlear level or in a vestibular one. This may cause an incapacitating symptomatology due to a hearing impairment or deafness, tinnitus, or a vertiginous syndrome. The objective of this work was to analyze the notifications of ototoxic ADRs registered in the FEDRA database of the Spanish Pharmacovigilance System for Medicinal products for Human Use (SEFV-H), manifested as tinnitus, describing epidemiological and prognostic factors, as well as active principles and associated therapeutic groups.
An observational retrospective study based on the incoming registers in the FEDRA database of the SEFV-H, with tinnitus symptomatology due to ototoxicity between 1984 and 2017 has been carried out. SPSS v.20.0 program has been used for the descriptive and inferential statistics searching elements related to the emergence, seriousness or recuperation of the tinnitus.
A total of 662 patients notifications were obtained with 899 suspected drugs. 64% of the patients were women. The average age was 55.8 years old. An 8.5% of the tinnitus were classified as serious, meaning a significant and persistent disability. Evaluating the causality through the modified Karch-Lasagna algorithm (SEFV-H algorithm), a causal group credible or well defined, was discovered in 48.6%. In the ATC ranking, the most frequent group of cause drugs was the N, nervous system. It was concluded, among others, that the seriousness is more significant in men and that the elder group have a great influence in the tinnitus recovery.
The appearance of tinnitus brought on by medical ototoxicity may determine an important limitation on the patient. A vestibular and cochlear function monitoring must be carried out on patients under treatment with high ototoxicity drugs. The task of the pharmacovigilance seems to be essential, by spreading its results and stimulating the ADR notifications in order to identify pharmacological threats.
药物不良反应(ADR)之一可能是耳毒性,累及耳蜗或前庭。这可能因听力受损、失聪、耳鸣或眩晕综合征而导致失能症状。本研究的目的是分析西班牙人用药品药物警戒系统(SEFV-H)的FEDRA数据库中登记的耳毒性ADR报告,这些报告表现为耳鸣,描述流行病学和预后因素,以及活性成分和相关治疗组。
基于SEFV-H的FEDRA数据库中的输入记录进行了一项观察性回顾性研究,研究对象为1984年至2017年间因耳毒性出现耳鸣症状的患者。使用SPSS v.20.0程序进行描述性和推断性统计,以寻找与耳鸣的发生、严重程度或恢复相关的因素。
共获得662例患者的报告,涉及899种可疑药物。64%的患者为女性。平均年龄为55.8岁。8.5%的耳鸣被归类为严重,意味着显著且持续的失能。通过改良的卡尔奇-拉萨尼亚算法(SEFV-H算法)评估因果关系,发现48.6%的病例为因果关系可信或明确的组。在解剖学治疗学化学(ATC)分类中,最常见的致病药物组是N,即神经系统药物。得出的结论包括,男性的严重程度更高,老年组对耳鸣恢复有很大影响等。
药物性耳毒性引起的耳鸣可能对患者造成重要限制。对于使用高耳毒性药物治疗的患者,必须进行前庭和耳蜗功能监测。药物警戒工作似乎至关重要,通过传播其结果并鼓励ADR报告,以识别药理学威胁。