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PARP 抑制剂相关急性肾衰竭:基于 FDA 不良事件报告系统数据库的真实世界研究。

PARP inhibitor-related acute renal failure: a real-world study based on the FDA adverse event reporting system database.

机构信息

Department of Pharmacy, National Cancer Center, National Clinical Research Center for Cancer, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.

Department of Cancer Prevention, National Cancer Center, National Clinical Research Center for Cancer, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.

出版信息

Expert Opin Drug Saf. 2024 Nov;23(11):1463-1471. doi: 10.1080/14740338.2024.2376690. Epub 2024 Jul 8.

Abstract

BACKGROUND

Current clinical trial data on PARP inhibitors (PARPis)-related acute renal failure (ARF) are not entirely representative of real-world situations. Therefore, in this study, the US Food and Drug Administration Adverse Event Reporting System (FAERS) was used to evaluate PARPis-related ARF.

RESEARCH DESIGN AND METHODS

Data were obtained from 1 January 2015, to 30 September 2023. ARF event reports were analyzed based on four algorithms. The time-to-onset (TTO) and clinical outcomes of PARPis-associated ARF were assessed.

RESULTS

The total included cases were 2726. Significant signals were observed for olaparib, niraparib, and rucaparib (reporting odds ratio (ROR): 1.62, 95% confidence interval (CI): 1.49-1.78, 1.25, 95% CI: 1.19-1.32 and 1.59, 95% CI: 1.47-1.72 respectively). The median TTO of ARF onset was 57, 36, and 85 days for olaparib, niraparib, and rucaparib, respectively. The proportion of deaths with olaparib (9.88%) was significantly higher than for niraparib (2.52%) and rucaparib (2.94%) ( < 0.005). The proportion of life-threatening adverse events associated with niraparib (4.89%) was significantly higher than for rucaparib (0.98%) ( < 0.005).

CONCLUSIONS

ARF and PARPi were related, with the exception of talazoparib. More emphasis should be given to PARPis-related ARF due to the high proportion of serious AEs and delayed adverse reactions.

摘要

背景

目前关于聚腺苷二磷酸核糖聚合酶抑制剂(PARPi)相关急性肾衰竭(ARF)的临床试验数据并不完全代表真实情况。因此,本研究使用美国食品和药物管理局不良事件报告系统(FAERS)评估 PARPi 相关的 ARF。

研究设计和方法

数据来自 2015 年 1 月 1 日至 2023 年 9 月 30 日。根据四种算法分析 ARF 事件报告。评估 PARPi 相关 ARF 的发病时间(TTO)和临床结局。

结果

共纳入 2726 例病例。奥拉帕利、尼拉帕利和鲁卡帕利均有显著信号(报告比值比(ROR):1.62,95%置信区间(CI):1.49-1.78,1.25,95%CI:1.19-1.32 和 1.59,95%CI:1.47-1.72)。ARF 发病的中位 TTO 分别为奥拉帕利 57 天、尼拉帕利 36 天和鲁卡帕利 85 天。奥拉帕利的死亡比例(9.88%)明显高于尼拉帕利(2.52%)和鲁卡帕利(2.94%)( < 0.005)。与鲁卡帕利(0.98%)相比,尼拉帕利(4.89%)与危及生命的不良事件相关的比例明显更高( < 0.005)。

结论

除他拉唑帕利外,ARF 与 PARPi 相关,AE 严重比例高,不良反应延迟,应更加重视 PARPi 相关 ARF。

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