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基于 FDA 不良事件报告系统的伐苯扎嗪相关神经不良事件的挖掘:上市后分析。

Mining of neurological adverse events associated with valbenazine: A post-marketing analysis based on FDA adverse event reporting system.

机构信息

Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou 450001, Henan, China.

Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou 450001, Henan, China.

出版信息

Gen Hosp Psychiatry. 2024 Sep-Oct;90:22-29. doi: 10.1016/j.genhosppsych.2024.06.005. Epub 2024 Jun 12.

Abstract

PURPOSE

Valbenazine is commonly used to treat tardive dyskinesia, and we conducted a pharmacovigilance analysis using the Food and Drug Administration Adverse Event Reporting System (FAERS) to evaluate neurological safety signals associated with valbenazine.

METHODS

Data was collected in FAERS from the second quarter of 2017 to the fourth quarter of 2023 for data cleaning. Neurological adverse event (AE) signals of valbenazine were mined by calculating reporting odds ratios (ROR), information component (IC) and empirical Bayesian geometric mean (EBGM). The serious and non-serious cases and signals were prioritized using a rating scale.

RESULTS

The number of neurological AE reports where the primary suspect (PS) drug was 8981 for valbenazine. Significant AE signals were identified by the preferred term (PT) analysis for valbenazine, including somnolence (ROR 19.69), tremor (ROR 15.17), and tardive dyskinesia (ROR 236.91), among which 18 AEs were identified as new signals. Patient age (p < 0.009) and sex (p = 0.197) might be associated with an increased risk of neurological AE severity. Notably, the association between valbenazine and neurological disorders remained when stratified by sex, age, and reporter type. AE timing analysis was performed for the drug and four moderate clinical priority signals [i.e., somnolence, balance disorder, parkinsonism, and akathisia (priorities 7)], showing the same early failure type profiles.

CONCLUSIONS

The increase in neurological safety signals is identified in the post-marketing research of valbenazine. Clinicians need to pay attention to not only common AEs but also be alert to new neurological AE signals when using valbenazine.

摘要

目的

瓦伦扎嗪常用于治疗迟发性运动障碍,我们使用食品和药物管理局不良事件报告系统(FAERS)进行了药物警戒分析,以评估与瓦伦扎嗪相关的神经安全性信号。

方法

从 2017 年第二季度到 2023 年第四季度,在 FAERS 中收集数据进行数据清理。通过计算报告比值比(ROR)、信息成分(IC)和经验贝叶斯几何平均值(EBGM),挖掘瓦伦扎嗪的神经不良事件(AE)信号。使用评级量表对严重和非严重病例和信号进行优先级排序。

结果

瓦伦扎嗪的主要怀疑(PS)药物的神经 AE 报告数量为 8981 例。通过瓦伦扎嗪的首选术语(PT)分析,确定了显著的 AE 信号,包括嗜睡(ROR 19.69)、震颤(ROR 15.17)和迟发性运动障碍(ROR 236.91),其中 18 种 AE 被确定为新信号。患者年龄(p<0.009)和性别(p=0.197)可能与神经 AE 严重程度的风险增加有关。值得注意的是,当按性别、年龄和报告类型分层时,瓦伦扎嗪与神经障碍之间的关联仍然存在。对药物和四个中度临床优先信号(即嗜睡、平衡障碍、帕金森病和静坐不能(优先级 7))进行 AE 时间分析,显示出相同的早期失效类型特征。

结论

在瓦伦扎嗪的上市后研究中发现神经安全性信号增加。临床医生在使用瓦伦扎嗪时,不仅要注意常见 AE,还要警惕新的神经 AE 信号。

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