Tan Juntao, Yu Yue, He Yuxin, Zheng Jiangyuan, Tan Qingzhu, Zhang Xiao, Wan Chao, Zhang Zhengyu, Wu Xiaoxin, Tan Rui
Operation Management Office, Affiliated Banan Hospital of Chongqing Medical University, Chongqing, China.
Senior Bioinformatician Department of Quantitative Health Sciences Mayo Clinic, Rochester, Minnesota.
Clin Ther. 2025 Jan;47(1):82-90. doi: 10.1016/j.clinthera.2024.11.007. Epub 2024 Dec 2.
The purpose of this study was to employ the US Food and Drug Administration (FDA) Adverse Event Reporting System (FAERS) database to mine and analyze adverse events related to iodinated contrast media (ICM), explore the characteristics of adverse events (AEs) including their occurrence and correlation strength between AEs and drugs, and to provide valuable insights for clinical use.
The FAERS database was queried, data from Q1 of 2004 to Q2 of 2023 were extracted, and AE reports targeting 5 ICMs as the primary suspects were collected. Data mining and analysis were carried out on relevant reports using the reporting odds ratio (ROR), proportional reporting ratio (PRR), Bayesian confidence propagation neural network (BCPNN), and empirical Bayes geometric mean (EBGM), while the standardized medical dictionary for regulatory activities (MedDRA) queries (SMQ) was used for systematic classification.
A total of 11,155,106 AE reports were retrieved from FAERS, with 2,412 for ioversol, 2,001 for iohexol, 987 for iodixanol, 1,154 for iopamidol, and 3,835 for iopromide. ICM-induced AE occurrence targeted 21 system organ classes (SOCs). A total of 329 significant disproportionality Preferred terms (PTs) conforming to the 4 algorithms were simultaneously retained. The results revealed that the medium and strong adverse drug reaction (ADR) signals of the 5 ICMs largely focused on "respiratory, thoracic and mediastinal disorders," "general disorders and administration site conditions," "immune system disorders," and "skin and subcutaneous tissue disorders." Ioversol (logROR = 1.21, P = 0.034) and iopromide (logROR = 1.32, P = 0.004) were both correlated with a higher incidence of a significant ADR signal, namely throat irritation, particularly in females. In addition, ioversol and iopromide also suggested that toxic nephropathy (logROR = -2.47, P < 0.001) and hyperhidrosis (logROR = -1.22, P = 0.001) were significant ADR signals, especially in males, respectively.
While the AE distribution of the 5 ICMs was consistent, there were variations in specific ADR signal characteristics, warranting further consideration and exploration.
本研究旨在利用美国食品药品监督管理局(FDA)不良事件报告系统(FAERS)数据库挖掘和分析与碘化造影剂(ICM)相关的不良事件,探讨不良事件的特征,包括其发生情况以及不良事件与药物之间的关联强度,并为临床应用提供有价值的见解。
查询FAERS数据库,提取2004年第一季度至2023年第二季度的数据,并收集以5种ICM为主要怀疑对象的不良事件报告。使用报告比值比(ROR)、比例报告比(PRR)、贝叶斯置信传播神经网络(BCPNN)和经验贝叶斯几何均值(EBGM)对相关报告进行数据挖掘和分析,同时使用监管活动医学词典(MedDRA)查询(SMQ)进行系统分类。
从FAERS中检索到总共11,155,106份不良事件报告,其中碘海醇2412份、碘克沙醇2001份、碘克酸987份、碘帕醇1154份、碘普罗胺3835份。ICM引起的不良事件发生涉及21个系统器官类别(SOCs)。同时保留了符合4种算法的总共329个显著不成比例的首选术语(PTs)。结果显示,这5种ICM的中度和重度药物不良反应(ADR)信号主要集中在“呼吸、胸及纵隔疾病”“全身性疾病及给药部位情况”“免疫系统疾病”和“皮肤及皮下组织疾病”。碘海醇(logROR = 1.21,P = 0.034)和碘普罗胺(logROR = 1.32,P = 0.004)均与显著ADR信号的较高发生率相关,即喉咙刺激,尤其在女性中。此外,碘海醇和碘普罗胺还分别提示,中毒性肾病(logROR = -2.47,P < 0.001)和多汗症(logROR = -1.22,P = 0.001)是显著的ADR信号,尤其在男性中。
虽然5种ICM的不良事件分布一致,但特定ADR信号特征存在差异,值得进一步关注和探索。