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药物性肾结石:一项使用美国食品药品监督管理局不良事件报告系统数据库的真实世界药物警戒研究。

Drug-induced kidney stones: a real-world pharmacovigilance study using the FDA adverse event reporting system database.

作者信息

Ding Pan, Luo Qinghua, Cao Leihua

机构信息

Department of urology, Nanchang People's Hospital, Nanchang, China.

出版信息

Front Pharmacol. 2025 Mar 27;16:1511115. doi: 10.3389/fphar.2025.1511115. eCollection 2025.

Abstract

OBJECTIVE

This study aims to identify the drugs most commonly associated with kidney stone-related adverse events using data from the FDA Adverse Event Reporting System (FAERS), providing insights for clinical reference regarding the use of these drugs.

METHODS

We utilized the Medical Dictionary for Regulatory Activities (MedDRA 26.0) preferred term "nephrolithiasis" to identify drug-related adverse events (ADEs) for kidney stones reported in FAERS from Q1 2004 to Q1 2024. Reporting odds ratio (ROR) was used to quantify the signal strength of these ADEs, and new risk signals for kidney stones were compared with drug labeling information to identify any previously unreported risks.

RESULTS

Out of 21,035,995 adverse events reported in FAERS, 38,307 were associated with kidney stones. The top 5 drugs most frequently linked to kidney stone cases were adalimumab (2,636 cases), infliximab (1,266 cases), interferon beta-1a (920 cases), sodium oxybate (877 cases), and teriparatide (836 cases). Notably, certain drugs like lansoprazole (ROR 7.2, 95% CI 6.62-7.84), Xywav (ROR 7.1, 95% CI 6.03-8.35), and teduglutide (ROR 5.54, 95% CI 4.83-6.36) showed significant risk signals. Of the 50 drugs identified, 33 were not previously labeled as carrying a risk of kidney stones.

CONCLUSION

Our analysis of FAERS data revealed new risk signals for kidney stones not indicated in the labels of 33 drugs. Close monitoring is recommended when using these medications, and further research is needed to investigate the mechanisms behind drug-induced kidney stone formation.

摘要

目的

本研究旨在利用美国食品药品监督管理局不良事件报告系统(FAERS)的数据,确定与肾结石相关不良事件最常相关的药物,为这些药物的使用提供临床参考见解。

方法

我们使用《监管活动医学词典》(MedDRA 26.0)的首选术语“肾结石”来识别2004年第一季度至2024年第一季度FAERS中报告的与肾结石相关的药物不良事件(ADEs)。报告比值比(ROR)用于量化这些ADEs的信号强度,并将新的肾结石风险信号与药物标签信息进行比较,以识别任何先前未报告的风险。

结果

在FAERS报告的21035995例不良事件中,38307例与肾结石有关。与肾结石病例最常相关的前5种药物是阿达木单抗(2636例)、英夫利昔单抗(1266例)、干扰素β-1a(920例)、羟丁酸钠(877例)和特立帕肽(836例)。值得注意的是,某些药物如兰索拉唑(ROR 7.2,95%CI 6.62-7.84)、Xywav(ROR 7.1,95%CI 6.03-8.35)和替度鲁肽(ROR 5.54,95%CI 4.83-6.36)显示出显著的风险信号。在确定的50种药物中,33种以前未被标记为有肾结石风险。

结论

我们对FAERS数据的分析揭示了33种药物标签中未表明的新的肾结石风险信号。使用这些药物时建议密切监测,需要进一步研究以调查药物性肾结石形成背后的机制。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fe4b/11983471/a34b56dbd11f/fphar-16-1511115-g001.jpg

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