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计划生育组织在2009年和2010年发现的米非司酮不良事件与美国食品药品监督管理局不良事件报告系统中的事件以及通过《信息自由法》获取的事件之比较。

Mifepristone Adverse Events Identified by Planned Parenthood in 2009 and 2010 Compared to Those in the FDA Adverse Event Reporting System and Those Obtained Through the Freedom of Information Act.

作者信息

Cirucci Christina A, Aultman Kathi A, Harrison Donna J

机构信息

Sewickley, PA.

Charlotte Lozier Institute.

出版信息

Health Serv Res Manag Epidemiol. 2021 Dec 21;8:23333928211068919. doi: 10.1177/23333928211068919. eCollection 2021 Jan-Dec.

DOI:10.1177/23333928211068919
PMID:34993274
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8724996/
Abstract

BACKGROUND

As part of the accelerated approval of mifepristone as an abortifacient in 2000, the Food and Drug Administration (FDA) required prescribers to report all serious adverse events (AEs) to the manufacturer who was required to report them to the FDA. This information is included in the FDA Adverse Event Reporting System (FAERS) and is available to the public online. The actual Adverse Event Reports (AERs) can be obtained through the Freedom of Information Act (FOIA).

METHODS

We compared the number of specific AEs and total AERs for mifepristone abortions from January 1, 2009 to December 31, 2010 from 1. Planned Parenthood abortion data published by Cleland et al. 2. FAERS online dashboard, and 3. AERs provided through FOIA and analyzed by Aultman et al.

RESULTS

Cleland identified 1530 Planned Parenthood mifepristone cases with specific AEs for 2009 and 2010. For this period, FAERS online dashboard includes a total (from all providers) of only 664, and the FDA released only 330 AERs through FOIA. Cleland identified 1158 ongoing pregnancies in 2009 and 2010. FAERs dashboard contains only 95, and only 39 were released via FOIA.

CONCLUSIONS

There are significant discrepancies in the total number of AERs and specific AEs for 2009 and 2010 mifepristone abortions reported in 1. Cleland's documentation of Planned Parenthood AEs, 2. FAERS dashboard, and 3. AERs provided through FOIA. These discrepancies render the FAERS inadequate to evaluate the safety of mifepristone abortions.

摘要

背景

作为2000年米非司酮作为堕胎药加速获批的一部分,美国食品药品监督管理局(FDA)要求开处方者向制造商报告所有严重不良事件(AE),而制造商则必须将这些事件报告给FDA。该信息包含在美国食品药品监督管理局不良事件报告系统(FAERS)中,并可在线向公众提供。实际的不良事件报告(AER)可通过《信息自由法》(FOIA)获取。

方法

我们比较了2009年1月1日至2010年12月31日米非司酮堕胎的特定不良事件数量和总不良事件报告数量,数据来源如下:1. 克莱兰等人公布的计划生育堕胎数据;2. FAERS在线仪表板;3. 通过《信息自由法》提供并由奥尔特曼等人分析的不良事件报告。

结果

克莱兰确定了2009年和2010年计划生育组织1530例米非司酮特定不良事件病例。在此期间,FAERS在线仪表板总共(来自所有提供者)仅包含664例,而FDA通过《信息自由法》仅公布了330份不良事件报告。克莱兰确定了2009年和2010年1158例持续妊娠病例。FAERS仪表板仅包含95例,通过《信息自由法》仅公布了39例。

结论

在2009年和2010年米非司酮堕胎的不良事件报告总数和特定不良事件方面,存在显著差异,具体体现在:1. 克莱兰对计划生育组织不良事件的记录;2. FAERS仪表板;3. 通过《信息自由法》提供的不良事件报告。这些差异使得FAERS不足以评估米非司酮堕胎的安全性。

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本文引用的文献

1
Deaths and Severe Adverse Events after the use of Mifepristone as an Abortifacient from September 2000 to February 2019.2000 年 9 月至 2019 年 2 月使用米非司酮作为堕胎药后的死亡和严重不良事件。
Issues Law Med. 2021 Spring;36(1):3-26.
2
Adoption of no-test and telehealth medication abortion care among independent abortion providers in response to COVID-19.独立堕胎服务提供者为应对新冠疫情而采用无检测和远程医疗药物流产护理。
Contracept X. 2020 Nov 21;2:100049. doi: 10.1016/j.conx.2020.100049. eCollection 2020.
3
Telemedicine and medical abortion: dispelling safety myths, with facts.
远程医疗与药物流产:用事实消除安全误区。
Mhealth. 2018 Feb 1;4:3. doi: 10.21037/mhealth.2018.01.01. eCollection 2018.
4
Efficacy and safety of medical abortion using mifepristone and buccal misoprostol through 63 days.米非司酮与口腔含服米索前列醇用于63天内药物流产的有效性和安全性。
Contraception. 2015 Apr;91(4):269-73. doi: 10.1016/j.contraception.2015.01.005. Epub 2015 Jan 13.
5
Significant adverse events and outcomes after medical abortion.药物流产后的重大不良事件和结局。
Obstet Gynecol. 2013 Jan;121(1):166-71. doi: 10.1097/aog.0b013e3182755763.
6
Analysis of severe adverse events related to the use of mifepristone as an abortifacient.米非司酮作为堕胎药使用相关严重不良事件的分析。
Ann Pharmacother. 2006 Feb;40(2):191-7. doi: 10.1345/aph.1G481. Epub 2005 Dec 27.