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加巴喷丁类药物相关的谵妄不良事件:一项基于美国食品药品监督管理局不良事件报告系统(FAERS)的2004年至2022年真实世界研究

Gabapentinoids-Related Delirium Adverse Events: A Real-World Study from 2004 to 2022 Based on FAERS.

作者信息

Nie Zhongbiao, Liang Cuilv, Li Zhihong, Han Xinqiang, Zhang Ran

机构信息

Department of Pharmacy, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan, 030032, People's Republic of China.

Department of Pharmacy, Second Affiliated Hospital, Fujian Medical University, Quanzhou, 362000, People's Republic of China.

出版信息

J Pain Res. 2024 Aug 5;17:2551-2559. doi: 10.2147/JPR.S473226. eCollection 2024.

Abstract

PURPOSE

This study comprehensively describes and evaluates the correlation between gabapentinoids and all types of delirium.

METHODS

We used AERSMine to select all adverse reaction data from 2004 Q1 to the 2022 Q4 in the FDA Adverse Event Reporting System (FAERS) database, and delirium events reported by gabapentinoids drugs were included in this study. Collected and analyzed the clinical details of these reports. We have developed four models. Among the four models, reporting odds ratio (ROR) and proportional reporting ratio (PRR) were used to evaluate the potential association between and delirium. We undertook a subgroup analysis for the age and sex cohorts.

RESULTS

A total of 2950 reports of gabapentinoids-related delirium was collected. Excluding cases with a history of delirium (Model 2), opioid drugs (Model 3), and other adverse events related to gabapentinoids drugs (Model 4), pain cases with gabapentin drugs as the main suspected drug were selected. In model 1, the reporting rates of delirium at the delirium and delirium tremens levels were higher in the gabapentinoids group than in the non-gabapentinoids group (ROR 1.09(1.05,1.13); ROR 1.54(1.16,2.04)). In model 2.3 the delira and the delirium level were higher in the gabapentinoids group (ROR 1.42(1.29,1.56), ROR 1.44(1.31,1.59); ROR 1.43(1.30,1.58), ROR 1.46(1.33,1.61)). There is no difference in delirium levels in Model 4. Delirium levels were higher in the gabapentinoids group than in the non-gabapentinoids group in ≥65 years old. The delirium and deliria levels were higher in the male group than in the female group.

CONCLUSION

The delirium adverse reactions of the gabapentinoids group were significantly higher than those of non-gabapentinoids group in the first three models. However, with the removal of confounding factors, there was no significant difference in this type of adverse reaction in Model 4. In elderly and male patients, the incidence of delirium with gabapentinoids was significantly increased.

摘要

目的

本研究全面描述并评估加巴喷丁类药物与各类谵妄之间的相关性。

方法

我们使用AERSMine从美国食品药品监督管理局不良事件报告系统(FAERS)数据库中选取2004年第一季度至2022年第四季度的所有不良反应数据,纳入加巴喷丁类药物报告的谵妄事件。收集并分析这些报告的临床细节。我们开发了四个模型。在这四个模型中,报告比值比(ROR)和比例报告比值(PRR)用于评估与谵妄之间的潜在关联。我们对年龄和性别队列进行了亚组分析。

结果

共收集到2950份与加巴喷丁类药物相关的谵妄报告。排除有谵妄病史的病例(模型2)、阿片类药物(模型3)以及与加巴喷丁类药物相关的其他不良事件(模型4),选取以加巴喷丁类药物为主要可疑药物的疼痛病例。在模型1中,加巴喷丁类药物组谵妄和震颤谵妄水平的报告率高于非加巴喷丁类药物组(ROR 1.09(1.05,1.13);ROR 1.54(1.16,2.04))。在模型2和3中,加巴喷丁类药物组谵妄和谵妄水平更高(ROR 1.42(1.29,1.56),ROR 1.44(1.31,1.59);ROR 1.43(1.30,1.58),ROR 1.46(1.33,1.61))。模型4中谵妄水平无差异。≥65岁人群中,加巴喷丁类药物组的谵妄水平高于非加巴喷丁类药物组。男性组的谵妄和谵妄状态水平高于女性组。

结论

在前三个模型中,加巴喷丁类药物组的谵妄不良反应显著高于非加巴喷丁类药物组。然而,去除混杂因素后,模型4中这类不良反应无显著差异。在老年和男性患者中,加巴喷丁类药物导致谵妄的发生率显著增加。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a00f/11314526/807905e9a967/JPR-17-2551-g0001.jpg

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