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氘代丁苯那嗪的安全性评估:来自FAERS数据库的真实世界不良事件分析

Safety assessment of deutetrabenazine: real-world adverse event analysis from the FAERS database.

作者信息

Shu Yanping, Wang Yuanhe, Liu Jiaoying, Hu Lingyan, Tong Sichao, Wu Gang, Zhu Xianlin

机构信息

Department of Psychiatry of Women and Children, The Second People's Hospital of Guizhou Province, Guiyang, China.

Department of Neurology, Huaining County People's Hospital, Anqing, China.

出版信息

Front Pharmacol. 2024 Dec 23;15:1498215. doi: 10.3389/fphar.2024.1498215. eCollection 2024.

Abstract

BACKGROUND

Deutetrabenazine is a widely used drug for the treatment of tardive dyskinesia (TD), and post-marketing testing is important. There is a lack of real-world, large-sample safety studies of deutetrabenazine. In this study, a pharmacovigilance analysis of deutetrabenazine was performed based on the FDA Adverse Event Reporting System (FAERS) database to evaluate its relevant safety signals for clinical reference.

METHODS

Adverse events (AEs) of FAERS with deutetrabenazine as the primary suspect drug were collected from the first quarter (Q1) of 2017 to Q1 of 2024. Reporting Odds Ratio (ROR), Proportional Reporting Ratio (PRR), Bayesian Confidence Propagation Neural Network (BCPNN), and Empirical Bayesian Geometric Mean (EBGM) were used to mine AEs risk signals of deutetrabenazine. AEs were standardized and classified using the System Organ Class (SOC) and Preferred Terms (PTs) from Medical Dictionary for Regulatory Activities (MedDRA) version 23.0.

RESULTS

A total of 3,583 AEs with deutetrabenazine as the primary suspect drug were collected in this study. We found that these AEs involved 23 SOCs, and the positive signals were mainly concentrated in systemic disease and various reactions at the site of administration (n = 1816, ROR = 1.23, PRR = 1.18, IC = 0.24, EBGM = 1.18), neurological disorders (n = 1736, ROR = 3.02, PRR = 2.60, IC = 1.38, EBGM = 2.60) and psychiatric disorders (n = 1,659, ROR = 4.15, PRR = 3.52, IC = 1.82, EBGM = 3.52). We eventually identified 100 valid PTs that met the criteria of the four algorithms. Drug ineffective, dyskinesia, depression, somnolence, suicidal ideation were considered to be the common PTs of deutetrabenazine. Tongue thrust (n = 4, ROR 253.47, PRR 253.35, IC 7.88, EBGM 235.95), grunting (n = 5, ROR 78.49, PRR 78.45, IC 6.26, EBGM 76.71) and drooling (n = 17, ROR 13.21, PRR 13.19, IC 3.72, EBGM 13.14) were not mentioned in the specification, but the high signal intensity suggested that they may be the potential adverse reactions.

CONCLUSION

The efficacy of deutetrabenazine may be accompanied by some potential adverse effects in several systems. Adverse events in psychiatric, neurologic, gastrointestinal and respiratory need to be monitored in clinical practice.

摘要

背景

氘代丁苯那嗪是一种广泛用于治疗迟发性运动障碍(TD)的药物,上市后监测很重要。目前缺乏关于氘代丁苯那嗪的真实世界、大样本安全性研究。本研究基于美国食品药品监督管理局不良事件报告系统(FAERS)数据库对氘代丁苯那嗪进行药物警戒分析,以评估其相关安全信号,供临床参考。

方法

收集2017年第一季度(Q1)至2024年Q1期间FAERS中以氘代丁苯那嗪为主要可疑药物的不良事件(AE)。采用报告比值比(ROR)、比例报告比值比(PRR)、贝叶斯置信传播神经网络(BCPNN)和经验贝叶斯几何均值(EBGM)挖掘氘代丁苯那嗪的AE风险信号。使用来自《监管活动医学词典》(MedDRA)第23.0版的系统器官分类(SOC)和首选术语(PT)对AE进行标准化和分类。

结果

本研究共收集到3583例以氘代丁苯那嗪为主要可疑药物的AE。我们发现这些AE涉及23个SOC,阳性信号主要集中在全身性疾病和给药部位的各种反应(n = 1816,ROR = 1.23,PRR = 1.18,IC = 0.24,EBGM = 1.18)、神经系统疾病(n = 1736,ROR = 3.02,PRR = 2.60,IC = 1.38,EBGM = 2.60)和精神疾病(n = 1659,ROR = 4.15,PRR = 3.52,IC = 1.82,EBGM = 3.52)。我们最终确定了100个符合四种算法标准的有效PT。药物无效、运动障碍、抑郁、嗜睡、自杀观念被认为是氘代丁苯那嗪的常见PT。伸舌(n = 4,ROR 253.47,PRR 253.35,IC 7.88,EBGM 235.95)、呼噜声(n = 5,ROR 78.49,PRR 78.45,IC 6.26,EBGM 76.71)和流涎(n = 17,ROR 13.21,PRR 13.19,IC 3.72,EBGM 13.14)在说明书中未提及,但高信号强度表明它们可能是潜在的不良反应。

结论

氘代丁苯那嗪的疗效可能伴随着多个系统的一些潜在不良反应。临床实践中需要监测精神、神经、胃肠和呼吸方面的不良事件。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5f8a/11701039/5dbaa9d30527/fphar-15-1498215-g001.jpg

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