Merino Diane, Gérard Alexandre Olivier, Thümmler Susanne, Ben Othman Nouha, Viard Delphine, Rocher Fanny, Destere Alexandre, Van Obberghen Elise Katheryne, Drici Milou-Daniel
Department of Psychiatry, University Hospital of Nice, 06000 Nice, France.
Department of Pharmacology and Pharmacovigilance Centre of Nice, University Hospital of Nice, 06000 Nice, France.
J Clin Med. 2022 Aug 9;11(16):4641. doi: 10.3390/jcm11164641.
Parosmia is a qualitative distortion of smell perception. Resulting from central causes, sinonasal diseases, and infections, parosmia has also been associated with medications. Therefore, we aimed to investigate potential signals for drugs associated with parosmia. VigiBase (the WHO pharmacovigilance database) was queried for all reports of "Parosmia" (MedDRA Preferred Term), registered up to 23 January 2022. Disproportionality analysis relied on the reporting odds ratio and the information component. A signal is detected when the lower end of the 95% confidence interval of the information component is positive. We found 14,032 reports of parosmia, with a median patient age of 53 years. Most reported drugs were antiinfectives, among which COVID-19 vaccines accounted for 27.1% of reports. Antibiotics and corticosteroids were involved in 6.8% and 4.6% of reports. Significant disproportionate reporting was detected for corticosteroids, antibiotics, drugs used in nicotine dependence, COVID-19 and HPV vaccines, serotonin-norepinephrine reuptake inhibitors (SNRI), and incretin mimetics. We suggest potential safety signals involving nicotine replacement therapies and vaccines. We also highlight the potential role of less suspected classes, such as SNRIs and incretin mimetics. An iatrogenic etiology should be evoked when parosmia occurs, especially in the elderly.
嗅觉倒错是嗅觉感知的质性扭曲。嗅觉倒错由中枢性病因、鼻鼻窦疾病和感染引起，也与药物有关。因此，我们旨在调查与嗅觉倒错相关的药物的潜在信号。我们查询了VigiBase（世界卫生组织药物警戒数据库）中截至2022年1月23日登记的所有“嗅觉倒错”（MedDRA首选术语）报告。不成比例分析依赖于报告比值比和信息成分。当信息成分的95%置信区间下限为正时，检测到信号。我们发现了14,032份嗅觉倒错报告，患者年龄中位数为53岁。报告的大多数药物是抗感染药，其中新冠疫苗占报告的27.1%。抗生素和皮质类固醇分别占报告的6.8%和4.6%。皮质类固醇、抗生素、用于尼古丁依赖的药物、新冠和人乳头瘤病毒疫苗、5-羟色胺-去甲肾上腺素再摄取抑制剂（SNRI）和肠促胰岛素类似物存在显著的不成比例报告。我们提出了涉及尼古丁替代疗法和疫苗的潜在安全信号。我们还强调了较少被怀疑的类别（如SNRI和肠促胰岛素类似物）的潜在作用。当出现嗅觉倒错时，应考虑医源性病因，尤其是在老年人中。
