Meng Long, Yang Bing, Qiu Feng, Jia Yuntao, Sun Shusen, Yang JunQing, Huang Jing
Department of Pharmacy, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
Nursing College, Chongqing Medical University, Chongqing, China.
Front Med (Lausanne). 2021 Feb 1;8:594043. doi: 10.3389/fmed.2021.594043. eCollection 2021.
Because of contradictory evidence from clinical trials, the association between angiotensin-converting enzyme inhibitors (ACEIs) and lung cancer needs further evaluation. As such, the current study is to assess disproportionate reporting of primary malignant lung cancer among reports for ACEIs submitted to the FDA adverse event reporting system utilizing a pharmacovigilance approach. We conducted a disproportionality analysis of primary malignant lung cancer adverse events associated with 10 ACEIs by calculating the reported odds ratios (ROR) and information component (IC) with 95% confidence intervals (CI). ROR was adjusted for sex, age, and reporting year by logistic regression analyses. From January 2004 to March 2020, a total of 622 cases of lung cancer adverse event reports were identified for ACEIs users. Significant disproportionate association was found for ACEIs as a drug class (ROR: 1.22, 95% CI: 1.13-1.32; IC: 0.28, 95% CI: 0.17-0.39. adjusted ROR: 1.23, 95% CI: 1.02-1.49). After stratification based on gender, a subset analysis suggested that female patients exhibited a significant disproportionate association, while male patients did not. Sensitivity analyses that limited the data by reporting region, comorbidity, and reporting year also showed similar trends. Statistical significant lung cancer signals were detected among patients who received ACEI, especially female patients. The disproportionality analysis of the FAERS database suggests mildly increased reporting of lung cancer among ACEI users. Further robust epidemiological studies are necessary to confirm this relationship.
由于临床试验的证据相互矛盾,血管紧张素转换酶抑制剂(ACEIs)与肺癌之间的关联需要进一步评估。因此,本研究旨在采用药物警戒方法,评估提交给美国食品药品监督管理局(FDA)不良事件报告系统的ACEIs报告中,原发性恶性肺癌的不成比例报告情况。我们通过计算报告比值比(ROR)和信息成分(IC)以及95%置信区间(CI),对与10种ACEIs相关的原发性恶性肺癌不良事件进行了不成比例分析。通过逻辑回归分析对ROR进行了性别、年龄和报告年份的校正。2004年1月至2020年3月,共识别出622例ACEIs使用者的肺癌不良事件报告。发现ACEIs作为一类药物存在显著的不成比例关联(ROR:1.22,95%CI:1.13 - 1.32;IC:0.28,95%CI:0.17 - 0.39,校正ROR:1.23,95%CI:1.02 - 1.49)。按性别分层后,亚组分析表明女性患者存在显著的不成比例关联,而男性患者则没有。通过报告地区、合并症和报告年份对数据进行限制的敏感性分析也显示出类似趋势。在接受ACEI治疗的患者中检测到了具有统计学意义的肺癌信号,尤其是女性患者。对FDA不良事件报告系统(FAERS)数据库的不成比例分析表明,ACEIs使用者中肺癌报告略有增加。需要进一步进行有力的流行病学研究来证实这种关系。