Ko SooJeong, Chang Se-Hyun, Chung Yeon Woong, Seo Young-Gyun, Kang Dong-Yoon, Kim Kwangsoo, Chang Dong-Jin, Choi In Young
Department of Medical Informatics, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
Department of Biomedicine & Health Sciences, The Catholic University of Korea, Seoul, Republic of Korea.
Pharmacoepidemiol Drug Saf. 2023 Dec;32(12):1341-1349. doi: 10.1002/pds.5663. Epub 2023 Jul 12.
Quetiapine is a drug used to treat schizophrenia, bipolar disorder, and major depressive disorder. However, it can cause mild or severe hepatic adverse events and rarely fatal liver damage. This study was aimed at investigating hepatic toxicity caused by quetiapine use by analyzing the information captured from hospital electronic health records by using the Observational Medical Outcomes Partnership common data model (CDM).
This was a retrospective observational study involving a nested case-control method. A CDM based on an electronic health record database from five hospitals between January 2009 and May 2020 was used. We analyzed the status of quetiapine use, adverse events, and hepatic impairment.
The numbers of patients with non-serious and severe hepatic adverse reactions were 2566 (5.05%) and 835 (1.64%) out of 50 766 patients, respectively. After adjusting for covariates, the odds ratio of hepatic adverse events was 2.35 (95% CI: 2.03-2.72), and the odds ratio of severe hepatic adverse events was 1.76 (95% CI: 1.16-2.66).
Our findings suggest that quetiapine should be cautiously used, and hepatic function should be monitored in patients using quetiapine because it can cause mild or severe hepatic adverse events, complications, and in rare cases, fatal liver damage.
喹硫平是一种用于治疗精神分裂症、双相情感障碍和重度抑郁症的药物。然而,它可引起轻度或重度肝脏不良事件,且极少导致致命性肝损伤。本研究旨在通过使用观察性医疗结局合作组织通用数据模型(CDM)分析从医院电子健康记录中获取的信息,调查使用喹硫平引起的肝毒性。
这是一项采用巢式病例对照方法的回顾性观察性研究。使用了基于2009年1月至2020年5月期间五家医院电子健康记录数据库的CDM。我们分析了喹硫平的使用情况、不良事件和肝功能损害情况。
在50766例患者中,发生非严重和严重肝脏不良反应的患者数量分别为2566例(5.05%)和835例(1.64%)。在对协变量进行校正后,肝脏不良事件的比值比为2.35(95%CI:2.03 - 2.72),严重肝脏不良事件的比值比为1.76(95%CI:1.16 - 2.66)。
我们的研究结果表明,喹硫平应谨慎使用,使用喹硫平的患者应监测肝功能,因为它可引起轻度或重度肝脏不良事件、并发症,在罕见情况下还可导致致命性肝损伤。