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世卫组织数据库中瑞德西韦疑似药物不良反应的快速审查;调查结果和影响。

Rapid review of suspected adverse drug events due to remdesivir in the WHO database; findings and implications.

机构信息

Department of Pharmacology, All India Institute of Medical Sciences , Jodhpur, India.

Department of Pharmacology, S.N. Medical College , Jodhpur, India.

出版信息

Expert Rev Clin Pharmacol. 2021 Jan;14(1):95-103. doi: 10.1080/17512433.2021.1856655. Epub 2020 Dec 29.

Abstract

: Remdesivir has shown promise in the management of patients with COVID-19 although recent studies have shown concerns with its effectiveness in practice. Despite this there is a need to document potential adverse drug events (ADEs) to guide future decisions as limited ADE data available before the COVID-19 pandemic. : Interrogation of WHO VigiBase® from 2015 to 2020 coupled with published studies of ADEs in COVID-19 patients. The main outcome measures are the extent of ADEs broken down by factors including age, seriousness, region and organ. : A total 1086 ADEs were reported from the 439 individual case reports up to July 19, 2020, in the VigiBase®, reduced to 1004 once duplicates were excluded. Almost all ADEs concerned COVID-19 patients (92.5%), with an appreciable number from the Americas (67.7%). The majority of ADEs were from males > 45 years and were serious (82.5%). An increase in hepatic enzymes (32.1%), renal injury (14.4%), rise in creatinine levels (11.2%), and respiratory failure (6.4%) were the most frequently reported ADEs. : Deterioration of liver and kidney function are frequently observed ADEs with remdesivir; consequently, patients should be monitored for these ADEs. The findings are in line with ADEs included in regulatory authority documents.

摘要

瑞德西韦在 COVID-19 患者的治疗中显示出了一定的前景,尽管最近的研究表明其在实践中的有效性存在问题。尽管如此,仍有必要记录潜在的药物不良反应(ADE),以指导未来的决策,因为在 COVID-19 大流行之前,可用的 ADE 数据有限。

对 2015 年至 2020 年期间的世界卫生组织监测系统(VigiBase)进行查询,并结合 COVID-19 患者 ADE 的已发表研究。主要的结局指标是按年龄、严重程度、地区和器官等因素分类的 ADE 发生率。

截至 2020 年 7 月 19 日,从 439 份个案报告中报告了总共 1086 例 ADE,排除重复报告后降至 1004 例。几乎所有的 ADE 都涉及 COVID-19 患者(92.5%),其中来自美洲的 ADE 数量相当可观(67.7%)。大多数 ADE 来自 45 岁以上的男性,且较为严重(82.5%)。肝酶升高(32.1%)、肾损伤(14.4%)、肌酐水平升高(11.2%)和呼吸衰竭(6.4%)是最常报告的 ADE。

瑞德西韦经常引起肝肾功能恶化等 ADE,因此应监测患者是否出现这些 ADE。这些发现与监管机构文件中包含的 ADE 一致。

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