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伏硫西汀上市后安全性评价:一项基于FAERS数据库的长达十年的药物警戒研究。

Post-marketing safety evaluation of Vortioxetine: A decade-long pharmacovigilance study based on the FAERS database.

作者信息

Wu Jianhong, Li Na, Gu Jun, Shen Yuan, Qiu Linghe, Zhu Ling

机构信息

Affiliated Mental Health Center of Jiangnan University, Wuxi Central Rehabilitation Hospital, Wuxi, Jiangsu 214151, China.

Taizhou People's Hospital, Taizhou, Jiangsu 225400, China.

出版信息

J Affect Disord. 2025 Jun 15;379:586-593. doi: 10.1016/j.jad.2025.03.007. Epub 2025 Mar 6.

DOI:10.1016/j.jad.2025.03.007
PMID:40044085
Abstract

This study evaluated adverse events (AEs) associated with Vortioxetine by analyzing extensive data from the U.S. Food and Drug Administration Adverse Event Reporting System (FAERS). We collected data from the FAERS database spanning ten years, from the first quarter of 2014 to the second quarter of 2024, focusing on drug-related AEs involving Vortioxetine. A comprehensive analysis was performed using multiple signal detection methods, including reporting odds ratio (ROR), proportional reporting ratio (PRR), Bayesian Confidence Propagation Neural Network (BCPNN), and Multi-item Gamma Poisson Shrinker (MGPS). Among 13,116 reports where Vortioxetine was identified as the primary suspect drug, AEs were categorized into 27 system organ classes (SOCs) and 146 preferred terms (PTs). The results highlighted significant signals for common AEs, such as psychiatric disorders, gastrointestinal disorders, and nervous system disorders. Notably, feeling guilty exhibited the strongest signal strength; however, its clinical relevance requires cautious interpretation. Additionally, the study identified novel signals not listed in the drug label but potentially of clinical value, such as hyperarousal and alcoholic, which were significantly associated with Vortioxetine. Of particular note, AEs related to sexual dysfunction were the most diverse, while suicidal ideation was the most frequently reported. The study also uncovered rare but noteworthy signals, including hallucination and olfactory disorders, dermatillomania, and bruxism, which warrant further attention. In conclusion, while Vortioxetine demonstrates multifaceted benefits in alleviating symptoms of depression, its clinical use requires a comprehensive evaluation of potential risks. Developing safe and rational treatment strategies is essential to optimize therapeutic outcomes.

摘要

本研究通过分析来自美国食品药品监督管理局不良事件报告系统(FAERS)的大量数据,评估了与伏硫西汀相关的不良事件(AE)。我们从FAERS数据库收集了2014年第一季度至2024年第二季度这十年的数据,重点关注涉及伏硫西汀的药物相关不良事件。使用多种信号检测方法进行了全面分析,包括报告比值比(ROR)、比例报告比(PRR)、贝叶斯置信传播神经网络(BCPNN)和多项目伽马泊松收缩器(MGPS)。在13116份将伏硫西汀确定为主要怀疑药物的报告中,不良事件被分类为27个系统器官类别(SOC)和146个首选术语(PT)。结果突出了常见不良事件的显著信号,如精神障碍、胃肠道疾病和神经系统疾病。值得注意的是,感到内疚表现出最强的信号强度;然而,其临床相关性需要谨慎解读。此外,该研究还发现了未在药物标签中列出但可能具有临床价值的新信号,如过度觉醒和酒精相关问题,它们与伏硫西汀显著相关。特别值得注意的是,与性功能障碍相关的不良事件种类最多,而自杀意念报告最为频繁。该研究还发现了罕见但值得关注的信号,包括幻觉和嗅觉障碍、皮肤搔抓症和磨牙症,值得进一步关注。总之,虽然伏硫西汀在缓解抑郁症状方面显示出多方面的益处,但其临床应用需要对潜在风险进行全面评估。制定安全合理的治疗策略对于优化治疗效果至关重要。

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