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阿托伐他汀的真实世界安全性评估:来自美国食品药品监督管理局不良事件报告系统(FAERS)的见解。

Real-world safety evaluation of atorvastatin: insights from the US FDA adverse event reporting system (FAERS).

作者信息

Wan Hongbing, Xu Xiuxiu, Yi Dasong, Shuai Kexin

机构信息

Department of Cardiology, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, China.

Department of Rehabilitation, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, China.

出版信息

Expert Opin Drug Saf. 2025 Mar;24(3):305-314. doi: 10.1080/14740338.2024.2424438. Epub 2024 Dec 5.

Abstract

OBJECTIVE

Given the extensive use of atorvastatin in managing cardiovascular conditions and the surge in reported adverse drug reactions (ADRs), this study leverages the FAERS database to comprehensively evaluate atorvastatin-associated adverse events, thereby enhancing our understanding of its safety profile in real-world settings.

METHODS

A retrospective observational pharmacovigilance study was conducted using FAERS data from Q1 2004 to Q1 2024. Four algorithms - ROR, PRR, BCPNN, and EBGM - were employed to detect signals of adverse events (AEs) linked to atorvastatin through disproportionality analysis.

RESULTS

Out of 17,627,340 reports in the FAERS database 81,955 involved atorvastatin. Consistently identified AEs across all four algorithms included musculoskeletal and connective tissue disorders, metabolic and nutritional disorders, and hepatobiliary disorders at the system organ class (SOC) level. A total of 4,575 significant disproportionate preferred terms (PTs) were observed across 23 SOCs, with key PTs being 'immune-mediated myositis,' 'type 2 diabetes mellitus,' 'necrotizing myositis,' 'autoimmune myositis,' and 'myopathy.' Additionally, unexpected AEs such as erectile dysfunction were identified. The median onset time for these AEs was 60 days, with most occurring within the first 30 days of treatment.

CONCLUSION

This study identified both expected and unexpected AEs associated with atorvastatin, highlighting the need for continued surveillance and providing valuable insights for clinicians to optimize atorvastatin use and address safety concerns.

摘要

目的

鉴于阿托伐他汀在心血管疾病管理中的广泛应用以及报告的药物不良反应(ADR)激增,本研究利用FAERS数据库全面评估与阿托伐他汀相关的不良事件,从而增进我们对其在现实环境中安全性概况的了解。

方法

使用2004年第一季度至2024年第一季度的FAERS数据进行了一项回顾性观察性药物警戒研究。采用四种算法——ROR、PRR、BCPNN和EBGM——通过不成比例分析检测与阿托伐他汀相关的不良事件(AE)信号。

结果

在FAERS数据库中的17,627,340份报告中,有81,955份涉及阿托伐他汀。在系统器官分类(SOC)层面,所有四种算法一致识别出的AE包括肌肉骨骼和结缔组织疾病、代谢和营养疾病以及肝胆疾病。在23个SOC中总共观察到4,575个显著不成比例的首选术语(PT),关键PT为“免疫介导性肌炎”、“2型糖尿病”、“坏死性肌炎”、“自身免疫性肌炎”和“肌病”。此外,还识别出了如勃起功能障碍等意外AE。这些AE的中位发病时间为60天,大多数发生在治疗的前30天内。

结论

本研究识别出了与阿托伐他汀相关的预期和意外AE,强调了持续监测的必要性,并为临床医生优化阿托伐他汀的使用和解决安全问题提供了有价值的见解。

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