阿伐替尼上市后药物警戒研究:基于美国食品药品监督管理局不良事件报告系统数据库的不良事件数据挖掘与分析。

A post-marketing pharmacovigilance study of avapritinib: Adverse event data mining and analysis based on the United States Food and Drug Administration Adverse Event Reporting System database.

机构信息

Department of Pharmacy, The First Affiliated Hospital of Bengbu Medical College, Bengbu, China.

School of Pharmacy, Bengbu Medical College, Bengbu, China.

出版信息

Br J Clin Pharmacol. 2024 Aug;90(8):1816-1826. doi: 10.1111/bcp.15673. Epub 2023 Feb 6.

Abstract

AIMS

Avapritinib was first approved by the FDA in January 2020 and represents the first precision-targeted drug for gastrointestinal stromal tumours. However, there is a lack of large-scale data relating to adverse events (AEs) related to its use. We aimed to explore the avapritinib-related AEs in real-world practice based on the post-marketing data.

METHODS

We extracted all avapritinib-related reports submitted to the FDA Adverse Event Reporting System (FAERS) by June 2022. Based on disproportionality analysis and Bayesian analysis, we then calculated the reporting odds ratio (ROR), proportional reporting ratio (PRR), information component (IC) and empirical Bayes geometric mean (EBGM) to evaluate whether there is a significant association between avapritinib and AEs. Gender, age and time to onset were comparable between haemorrhage/non-haemorrhage, serious/non-serious, death/non-death AEs, respectively.

RESULTS

In total, 3120 cases related to avapritinib were documented in the FAERS database, and 44% were reported within 30 days of commencing avapritinib. A total of 331 different AE signals were detected, and no significant differences between males and females was identified. Although the number of AEs associated with an abnormal skin texture and executive dysfunction was small, the signal intensity is high, suggesting that these events are strongly correlated with avapritinib. Subgroup analysis showed that elderly male patients were more likely to suffer from serious AEs compared to females (P < .01), but there was no significant difference between the haemorrhage group and the non-haemorrhage group. Analysis of fatalities due to avapritinib-related AEs indicated that sex, age and time-to-onset were all significantly related to death (P < .05).

CONCLUSION

Our study provides a more precise description of the incidence and characteristics of AEs after using avapritinib, clinicians should be particularly careful when prescribing avapritinib to elderly male patients, especially within the 30 days.

摘要

目的

阿伐替尼于 2020 年 1 月首次获得 FDA 批准,是首个针对胃肠间质瘤的精准靶向药物。然而,目前缺乏关于其使用相关不良事件(AE)的大规模数据。我们旨在根据上市后数据,探索阿伐替尼在真实世界实践中的相关 AE。

方法

我们提取了截至 2022 年 6 月向 FDA 不良事件报告系统(FAERS)提交的所有与阿伐替尼相关的报告。然后,基于比例失衡分析和贝叶斯分析,我们计算了报告比值比(ROR)、比例报告比(PRR)、信息成分(IC)和经验贝叶斯几何平均值(EBGM),以评估阿伐替尼与 AE 之间是否存在显著关联。出血/非出血、严重/非严重、死亡/非死亡 AE 之间的性别、年龄和发病时间具有可比性。

结果

在 FAERS 数据库中,共记录了 3120 例与阿伐替尼相关的病例,其中 44%在开始使用阿伐替尼后 30 天内报告。共检测到 331 种不同的 AE 信号,未发现男女之间存在显著差异。虽然与异常皮肤纹理和执行功能障碍相关的 AE 数量较少,但信号强度较高,表明这些事件与阿伐替尼密切相关。亚组分析显示,与女性相比,老年男性更易发生严重 AE(P<0.01),但出血组与非出血组之间无显著差异。对阿伐替尼相关 AE 导致的死亡分析表明,性别、年龄和发病时间均与死亡显著相关(P<0.05)。

结论

本研究更精确地描述了使用阿伐替尼后 AE 的发生率和特征,临床医生在为老年男性患者开具阿伐替尼处方时应格外小心,尤其是在 30 天内。

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