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一项关于阿维鲁单抗的美国食品药品监督管理局不良事件报告系统事件的真实世界药物警戒研究。

A Real-World Pharmacovigilance Study of FDA Adverse Event Reporting System Events for Avelumab.

作者信息

He Lu, Zhang Xinyue, Li Yanrong, Li Rongrong, Hou Encun

机构信息

Oncology, Guangxi University of Chinese Medicine, Nanning, CHN.

Oncology, Ruikang Hospital, Guangxi University of Chinese Medicine, Nanning, CHN.

出版信息

Cureus. 2025 Mar 27;17(3):e81285. doi: 10.7759/cureus.81285. eCollection 2025 Mar.

Abstract

Background This study utilized data from the FDA Adverse Event Reporting System (FAERS) to investigate adverse drug events (ADEs) associated with avelumab, spanning from the third quarter of 2015 to the first quarter of 2024. Methodology We collected and normalized avelumab ADE data from Q3 2015 to Q1 2024. To ensure robust signal detection and accurate measurement of association strength, we employed key techniques, including the reporting odds ratio (ROR), proportional reporting ratio (PRR), Bayesian confidence propagation neural network (BCPNN), and empirical Bayes geometric mean (EBGM). These methods allowed for the comparison of event proportions, consideration of uncertainties, and adjustment for reporting variability, ensuring reliable signal quantification and analysis. Results In our review of 3,978 ADE reports, we classified unique preferred terms (PTs) into 22 systematic organ classifications (SOCs) to detail the range of avelumab-associated adverse reactions. The most commonly reported SOC was "General disease and administration site conditions," with 868 cases reported (ROR = 1.22, PRR = 1.17, IC = 0.23, EBGM = 1.17). The second was nervous system disorders (294 cases) (ROR = 0.9, PRR = 0.91, IC = 0.14, EBGM = 0.91). The incidence of "Injury, poisoning and procedural complications" was 253 cases (ROR = 0.52, PRR = 0.55, IC = 0.86, EBGM = 0.55). This rank highlighted significant differences in the frequency and risk indicators of these diseases. It is worth noting that PTs with strong signals detected included thrombocytopenia (n = 35, ROR = 4.98, PRR = 4.95, IC = 2.31, EBGM = 4.95), hypothyroidism (n = 31, ROR = 15.49, PRR = 15.38, IC = 3.94, EBGM = 15.36), and renal impairment (n = 23, ROR = 3.93, PRR = 3.91, IC = 1.97, EBGM = 3.91). Conclusions While avelumab offers significant therapeutic benefits, its use carries potential adverse effects. Clinicians must remain vigilant in monitoring patients, particularly for severe symptoms, such as thrombocytopenia, hypothyroidism, and renal impairment, to ensure prompt intervention and minimize risks. Early detection of these and other potential events will help healthcare providers better manage and mitigate the risks associated with avelumab treatment.

摘要

背景 本研究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,调查2015年第三季度至2024年第一季度与阿维鲁单抗相关的药物不良事件(ADEs)。方法 我们收集并标准化了2015年第三季度至2024年第一季度的阿维鲁单抗ADE数据。为确保强大的信号检测和关联强度的准确测量,我们采用了关键技术,包括报告比值比(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)。这些方法允许比较事件比例、考虑不确定性并调整报告变异性,确保可靠的信号量化和分析。结果 在我们对3978份ADE报告的审查中,我们将独特的首选术语(PTs)分类为22个系统器官分类(SOCs),以详细说明与阿维鲁单抗相关的不良反应范围。报告最常见的SOC是“一般疾病和给药部位状况”,报告了868例(ROR = 1.22,PRR = 1.17,IC = 0.23,EBGM = 1.17)。其次是神经系统疾病(294例)(ROR = 0.9,PRR = 0.91,IC = 0.14,EBGM = 0.91)。“损伤、中毒和手术并发症”的发生率为253例(ROR = 0.52,PRR = 0.55,IC = 0.86,EBGM = 0.55)。这一排名突出了这些疾病在频率和风险指标上的显著差异。值得注意的是,检测到的信号较强的PTs包括血小板减少症(n = 35,ROR = 4.98,PRR = 4.95,IC = 2.31,EBGM = 4.95)、甲状腺功能减退症(n = 31,ROR = 15.49,PRR = 15.38,IC = 3.94,EBGM = 15.36)和肾功能损害(n = 23,ROR = 3.93,PRR = 3.91,IC = 1.97,EBGM = 3.91)。结论 虽然阿维鲁单抗具有显著的治疗益处,但其使用存在潜在不良反应。临床医生必须保持警惕,监测患者,特别是对于严重症状,如血小板减少症、甲状腺功能减退症和肾功能损害,以确保及时干预并将风险降至最低。早期发现这些及其他潜在事件将有助于医疗保健提供者更好地管理和减轻与阿维鲁单抗治疗相关 的风险。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d338/12032950/30e14241a259/cureus-0017-00000081285-i01.jpg

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