Chakraborty Shubhadeep, Tiwari Ram
Bristol Myers Squibb Company, Princeton, NJ, USA.
Global Stat Solutions, Reston, VA, USA.
Ther Innov Regul Sci. 2025 Jan;59(1):89-101. doi: 10.1007/s43441-024-00705-7. Epub 2024 Oct 20.
Post-marketing surveillance refers to the process of monitoring the safety of drugs once they reach the market, after the successful completion of clinical trials. In this work, we investigate a computational approach using data mining tools to detect safety signals from post-market safety databases, or in other words, to identify adverse events (AEs) with disproportionately high reporting rates compared to other AEs, associated with a particular drug or a drug class. Essentially, we view this as a problem of cluster analysis-based anomaly detection on post-market safety data, where the goal is to 'unsupervisedly' detect the anomalous or the signal AEs. Our findings demonstrate the potential of using a clustering ensemble method to detect drug safety signals. It employs multiple clustering or anomaly detection algorithms, followed by a performance comparison of the candidate algorithms based on a collection of appropriate measures of goodness of clustering results. The method is general enough to include any number of clustering or anomaly detection algorithms and goodness measures, and performs better than any of the candidate algorithms in identifying the signal AEs. Extensive simulation studies illustrate that the ensemble method detects the AE signals from synthetic post-market safety datasets pretty accurately across the different scenarios explored. Based on the cases reported to the FDA Adverse Event Reporting System (FAERS) between 2013 and 2022, we further demonstrate that the ensemble method successfully identifies and confirms most of the adverse events that are known to occur most frequently in reaction to antiepileptic drugs and -lactam antibiotics.
上市后监测是指在临床试验成功完成后,对药品进入市场后的安全性进行监测的过程。在这项工作中,我们研究了一种使用数据挖掘工具的计算方法,以从上市后安全数据库中检测安全信号,或者换句话说,识别与特定药物或药物类别相关的、报告率相比其他不良事件异常高的不良事件(AE)。从本质上讲,我们将此视为基于聚类分析的异常检测问题,针对上市后安全数据,目标是“无监督地”检测异常或信号不良事件。我们的研究结果证明了使用聚类集成方法检测药物安全信号的潜力。它采用多种聚类或异常检测算法,然后基于一组适当的聚类结果优良性度量对候选算法进行性能比较。该方法具有足够的通用性,可以包括任意数量的聚类或异常检测算法以及优良性度量,并且在识别信号不良事件方面比任何候选算法表现都更好。广泛的模拟研究表明,在探索的不同场景中,集成方法能够非常准确地从合成的上市后安全数据集中检测出不良事件信号。基于2013年至2022年向美国食品药品监督管理局不良事件报告系统(FAERS)报告的病例,我们进一步证明,集成方法成功识别并确认了大多数已知在抗癫痫药物和β-内酰胺类抗生素反应中最常发生的不良事件。