Chi Whanhui, Lee Hye Jung, Chong Yong Pil
Pfizer Inc, Seoul, Republic of Korea.
Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
Infect Dis Ther. 2021 Mar;10(1):411-420. doi: 10.1007/s40121-021-00398-7. Epub 2021 Jan 22.
Safety data can be collected through prospective and retrospective methods during post-marketing surveillance (PMS). This study aimed to compare prospective and retrospective methods in terms of examining safety data from PMS of tigecycline.
This PMS study was an open-label, noncomparative, observational, noninterventional and multicenter study of patients who received tigecycline for infections. From July 2007 to April 2015, 3172 patients were included in this study, of which 738 were enrolled prospectively and 2434 retrospectively. To reduce selection bias, demographic and baseline characteristics were adjusted using 1:2 propensity score matching.
After propensity score matching, data from 1446 patients were analyzed. The incidences of adverse events (AEs) and serious AEs (SAEs) were determined to be significantly higher in the prospective method compared with those of the retrospective method (P < 0.001 and P = 0.004, respectively). However, no significant differences in the incidences of adverse drug reactions (ADRs) and serious ADRs (SADRs) were detected between the two groups (P = 0.09 and P = 0.33, respectively). In a subgroup analysis of 360 patients from 14 hospitals involved in both prospective and retrospective methods, the incidence of AEs was found to be significantly higher using the prospective method compared with when the retrospective method was used (P < 0.001), but there were no significant differences in ADRs (P = 0.14), SAEs (P = 0.24) and SADRs.
In general, the prospective method can detect safety data effectively in a PMS study, whereas retrospective data collection may be an alternative option in collecting ADR data when a prospective PMS study is not deemed feasible.
在上市后监测(PMS)期间,可以通过前瞻性和回顾性方法收集安全性数据。本研究旨在比较前瞻性和回顾性方法在检查替加环素上市后监测安全性数据方面的差异。
本上市后监测研究是一项针对接受替加环素治疗感染患者的开放标签、非对照、观察性、非干预性多中心研究。2007年7月至2015年4月,本研究纳入3172例患者,其中738例为前瞻性入组,2434例为回顾性入组。为减少选择偏倚,使用1:2倾向评分匹配对人口统计学和基线特征进行调整。
经过倾向评分匹配后,对1446例患者的数据进行了分析。结果显示,前瞻性方法中不良事件(AE)和严重不良事件(SAE)的发生率显著高于回顾性方法(分别为P < 0.001和P = 0.004)。然而,两组之间药物不良反应(ADR)和严重药物不良反应(SADR)的发生率未检测到显著差异(分别为P = 0.09和P = 0.33)。在参与前瞻性和回顾性方法的14家医院的360例患者亚组分析中,发现前瞻性方法的AE发生率显著高于回顾性方法(P < 0.001),但ADR(P = 0.14)、SAE(P = 0.24)和SADR方面无显著差异。
总体而言,前瞻性方法可以在上市后监测研究中有效地检测安全性数据,而当认为前瞻性上市后监测研究不可行时,回顾性数据收集可能是收集ADR数据的另一种选择。