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日本替加环素安全性和疗效的药物使用调查(全病例上市后监测)。

Drug use investigation on the safety and efficacy of tigecycline in Japan (all-case post-marketing surveillance).

机构信息

Hospital Business Unit, Medical Affairs Department, Pfizer Japan Inc., Japan.

Biometrics and Data Management Department, Clinical Statistics Group 2, Pfizer R&D, Japan.

出版信息

J Infect Chemother. 2022 Jul;28(7):866-874. doi: 10.1016/j.jiac.2022.03.003. Epub 2022 Mar 30.

Abstract

INTRODUCTION

We conducted a drug use investigation to investigate the safety and efficacy of tigecycline, which has been approved for clinical use for the treatment of multidrug-resistant gram-negative infections in Japan.

METHODS

This was an open-label, observational, multicenter cohort study that included all patients who received tigecycline.

RESULTS

A total of 116 patients were registered between December 2012 and April 2016 and all of them were evaluated for safety and efficacy. Among them, 64 patients aged ≥65 years (55.2%) and five children aged <15 years (4.3%) were included. Of these patients, 47 (40.5%) met the approved indications of tigecycline. Adverse drug reactions (ADRs) were observed in 41 patients (35.3%) with a total of 74 events. Serious ADRs were observed in 15 patients (12.93%) with a total of 33 events. There were 42 deaths, and 6 of these were considered to be caused by ADRs. Among the 116 patients, 65 achieved clinical response at the end of the observation period, and the efficacy rate was 73.9%. Furthermore, 46 patients were assessed as "cure" at the test of cure visit, and the cure rate was 59.0%. The eradication rate was 47.5% at the end of the observation period. Classified by pathogenic bacteria, the eradication rate of patients infected with the approved pathogens was 54.5%.

CONCLUSIONS

Tigecycline was well-tolerated, and no additional safety concerns were noted. It was effective considering that most patients had poor physical conditions. The overall benefit-risk balance of tigecycline was favorable.

摘要

简介

我们进行了一项药物使用调查,以研究替加环素的安全性和疗效。替加环素已在日本获得批准,用于治疗多重耐药革兰氏阴性感染。

方法

这是一项开放标签、观察性、多中心队列研究,纳入了所有接受替加环素治疗的患者。

结果

2012 年 12 月至 2016 年 4 月期间共登记了 116 例患者,所有患者均进行了安全性和疗效评估。其中,64 例患者(55.2%)年龄≥65 岁,5 例儿童(4.3%)年龄<15 岁。这些患者中,47 例(40.5%)符合替加环素的批准适应证。41 例(35.3%)患者发生了药物不良反应(ADR),共 74 例次。15 例(12.93%)患者发生严重 ADR,共 33 例次。共有 42 例死亡,其中 6 例被认为与 ADR 有关。在 116 例患者中,65 例在观察期末达到临床缓解,有效率为 73.9%。进一步在治愈性评估访视中,46 例被评估为“治愈”,治愈率为 59.0%。观察期末的清除率为 47.5%。按病原菌分类,批准的病原菌感染患者的清除率为 54.5%。

结论

替加环素具有良好的耐受性,未发现其他安全性问题。考虑到大多数患者的身体状况较差,该药物具有良好的疗效。替加环素的总体获益-风险平衡有利。

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