Int J Clin Pharmacol Ther. 2022 Sep;60(9):402-407. doi: 10.5414/CP204255.
Juvenile idiopathic arthritis (JIA) is a systemic inflammatory disease of childhood onset. The purpose of this study was to clarify the frequency of adverse events caused by drugs used in JIA treatment and characterize their safety profiles using a spontaneous reporting system database. We performed a retrospective pharmacovigilance disproportionality analysis using the Japanese Adverse Drug Event Report (JADER) database. Adverse event reports on drugs used for the treatment of JIA and which were submitted to the Pharmaceuticals and Medical Devices Agency were analyzed, and the reporting odds ratio (ROR) and 95% confidence interval (CI) for reports on each adverse event were calculated. A total of 5,748 reports were identified in the treatment of JIA, in which 35 different drugs were involved. Adverse events by drugs in JIA were frequently reported in females (64.3%) and in those younger than 10 (61.2%). Among the most frequently reported drugs, prednisolone (36.8%) and tocilizumab (36.0%) were predominant. Prednisolone was significantly correlated with hematophagic histiocytosis (ROR, 1.37; 95% CI, 1.18 - 1.61). Tocilizumab was associated with a high ROR for pneumonia (ROR, 8.61: 95% CI, 5.81 - 12.7), a decreased neutrophil count (ROR, 6.1; 95% CI, 4.07 - 9.16), and lymphadenitis (ROR, 8.34; 95% CI, 4.2 - 16.6). Our results revealed the safety profile of drugs for the treatment of JIA patients. It was suggested that there is a diversity in drugs and their strength of association with adverse events in JIA patients. Our results may provide useful information for the treatment of JIA patients, although further research with more data is needed.
幼年特发性关节炎(JIA)是一种儿童起病的全身性炎症性疾病。本研究旨在使用自发报告系统数据库阐明 JIA 治疗药物引起的不良事件的频率,并描述其安全性特征。我们使用日本药物不良反应报告(JADER)数据库进行了回顾性药物警戒性比例失调分析。分析了报告给药品和医疗器械管理局的用于治疗 JIA 的药物的不良事件报告,并计算了每种不良事件报告的报告比值比(ROR)和 95%置信区间(CI)。在 JIA 的治疗中,共确定了 5748 例报告,其中涉及 35 种不同的药物。JIA 中药物的不良事件在女性(64.3%)和 10 岁以下儿童(61.2%)中经常报告。在报告最多的药物中,泼尼松龙(36.8%)和托珠单抗(36.0%)占主导地位。泼尼松龙与噬血细胞性组织细胞增多症显著相关(ROR,1.37;95%CI,1.18-1.61)。托珠单抗与肺炎的高 ROR 相关(ROR,8.61:95%CI,5.81-12.7)、中性粒细胞计数减少(ROR,6.1;95%CI,4.07-9.16)和淋巴结炎(ROR,8.34;95%CI,4.2-16.6)。我们的结果揭示了治疗 JIA 患者的药物安全性特征。这表明 JIA 患者的药物种类及其与不良事件的关联强度存在多样性。我们的结果可能为 JIA 患者的治疗提供有用信息,尽管需要更多数据的进一步研究。