Liu Mingdi, Gu Liting, Zhang Yuning, Zhou Honglan, Wang Yishu, Xu Zhi-Xiang
Key Laboratory of Pathobiology, Ministry of Education, Jilin University, Changchun, Jilin, China.
Department of Urology, The First Hospital of Jilin University, Changchun, Jilin, China.
Front Pharmacol. 2024 Jan 31;15:1290975. doi: 10.3389/fphar.2024.1290975. eCollection 2024.
Mesalazine, a preparation of 5-aminosalicylic acid, is a medication widely used in clinical practice as a first-line therapy in the treatment of mild and moderate inflammatory bowel disease. However, the long-term safety of mesalazine in large sample population was unknown. The current study was to assess mesalazine -related adverse events of real-world through data mining of the US Food and Drug Administration Adverse Event Reporting System (FAERS). Disproportionality analyses, including the reporting odds ratio (ROR), the proportional reporting ratio the Bayesian confidence propagation neural network and the multi-item gamma Poisson shrinker (MGPS) algorithms were employed to quantify the signals of mesalazine -associated AEs. Out of 14,149,980 reports collected from the FDA Adverse Event Reporting System database, 24,284 reports of mesalazine -associated AEs were identified. A total of 170 significant disproportionality preferred terms conforming to the four algorithms simultaneously were retained. The most common AEs included colitis ulcerative, diarrhoea, condition aggravated, crohn's disease, fatigue, abdominal pain, nausea, haematochezia, which were corresponding to those reported in the specification and clinical trials. Unexpected significant AEs as dizziness, drug ineffective, drug hypersensitivity, infection, off label use, weight decreased, decreased appetite, arthralgia, rash might also occur. The median onset time of mesalazine -related AEs was 1,127 days (interquartile range [IQR] 1,127-1,674 days), and most of the cases occurred 2 years later (n = 610, 70.93%) and within the first 1 month (n = 89, 10.35%) after mesalazine initiation. Results of our study were consistent with clinical observations. We also found potential new and unexpected AEs signals for mesalazine, suggesting prospective clinical studies were needed to confirm these results and illustrate their relationship. Our results could provide valuable evidence for further safety studies of mesalazine.
美沙拉嗪是5-氨基水杨酸的一种制剂,作为治疗轻、中度炎症性肠病的一线疗法,在临床实践中被广泛使用。然而,美沙拉嗪在大样本人群中的长期安全性尚不清楚。本研究旨在通过对美国食品药品监督管理局不良事件报告系统(FAERS)的数据挖掘,评估美沙拉嗪在现实世界中的相关不良事件。采用不成比例分析,包括报告比值比(ROR)、比例报告比、贝叶斯置信传播神经网络和多项目伽马泊松收缩器(MGPS)算法,对美沙拉嗪相关不良事件的信号进行量化。从FDA不良事件报告系统数据库收集的14149980份报告中,识别出24284份美沙拉嗪相关不良事件报告。总共保留了170个同时符合四种算法的显著不成比例的首选术语。最常见的不良事件包括溃疡性结肠炎、腹泻、病情加重、克罗恩病、疲劳、腹痛、恶心、便血,这些与说明书和临床试验中报告的一致。也可能出现意外的显著不良事件,如头晕、药物无效、药物过敏、感染、超适应症用药、体重减轻、食欲减退、关节痛、皮疹。美沙拉嗪相关不良事件的中位发病时间为1127天(四分位间距[IQR]为1127 - 1674天),大多数病例发生在美沙拉嗪开始使用后的2年(n = 610,70.93%)和前1个月内(n = 89,10.35%)。我们的研究结果与临床观察一致。我们还发现了美沙拉嗪潜在的新的和意外的不良事件信号,表明需要进行前瞻性临床研究来证实这些结果并阐明它们之间的关系。我们的结果可为美沙拉嗪的进一步安全性研究提供有价值的证据。