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全身用喹诺酮类药物与视网膜脱离风险 I:美国 FDA 不良事件报告系统数据分析。

Systemic quinolones and risk of retinal detachment I: analysis of data from the US FDA adverse event reporting system.

机构信息

McLaughlin Centre for Population Health Risk Assessment, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada.

School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada.

出版信息

Expert Opin Drug Saf. 2022 Feb;21(2):269-276. doi: 10.1080/14740338.2022.1993187. Epub 2021 Oct 24.

DOI:10.1080/14740338.2022.1993187
PMID:34641748
Abstract

BACKGROUND

Quinolones comprise a class of antibiotics that are globally preferred for treating a wide range of bacterial infections due to their potency, broad coverage, favorable pharmacologic profile, and mostly mild to moderate adverse reactions. Spontaneous reports on adverse drug events (ADE) and data from some pharmacoepidemiologic studies have raised concerns regarding quinolones and risk of retinal detachment (RD). This study examined ADE reports submitted to FDA adverse event reporting system (FAERS) for evidence on quinolone-associated RD risk.

RESEARCH DESIGN AND METHODS

We identified all RD reports in FAERS between 2010-2019. We compared ADE signals between quinolones and selected medications that were previously associated with RD, and with reference medications not known to cause RD. For signal detection, we used two techniques: the proportional reporting ratio (PRR) and multi-item gamma Poisson shrinker (MGPS), which are known for their higher sensitivity and specificity for ADE signal detection, respectively.

RESULTS

Moxifloxacin showed a positive and significant PRR signal for RD [PRR: 2.54 (1.60, 4.04)], and a marginally significant EBGM signal [EBGM: 2.21 (1.41, 3.02)].

CONCLUSION

Moxifloxacin is the only quinolone showing a positive disproportionality signal for RD. Further epidemiologic research is needed to clarify the association between moxifloxacin and RD risk.

摘要

背景

喹诺酮类抗生素是一类广泛用于治疗多种细菌感染的抗生素,由于其效力高、覆盖面广、药代动力学特性良好,以及不良反应多为轻度至中度,因此在全球范围内受到青睐。药物不良反应(ADE)的自发报告和一些药物流行病学研究的数据引起了人们对喹诺酮类药物和视网膜脱离(RD)风险的关注。本研究通过美国食品和药物管理局不良事件报告系统(FAERS)中的 ADE 报告,调查了与喹诺酮类药物相关的 RD 风险的证据。

研究设计与方法

我们在 FAERS 中确定了 2010 年至 2019 年间所有的 RD 报告。我们比较了喹诺酮类药物与以前与 RD 相关的选定药物以及与已知不会引起 RD 的参考药物的 ADE 信号。对于信号检测,我们使用了两种技术:比例报告比(PRR)和多项目伽马泊松收缩器(MGPS),它们分别以其对 ADE 信号检测的更高灵敏度和特异性而闻名。

结果

莫西沙星对 RD 有阳性且显著的 PRR 信号[PRR:2.54(1.60,4.04)],并且有边缘显著的 EBGM 信号[EBGM:2.21(1.41,3.02)]。

结论

莫西沙星是唯一对 RD 显示出阳性不成比例信号的喹诺酮类药物。需要进一步的流行病学研究来阐明莫西沙星与 RD 风险之间的关联。

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