Di Xingwei, Jiang Jiazhen, Zhong Qian, Zhou Xinyu, Zhou Lisi, Zheng Jiyuan, Liu Bingshuo
Department of Cardiovascular Medicine, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China.
The First Clinical Medical School of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China.
Front Cardiovasc Med. 2025 May 6;12:1504671. doi: 10.3389/fcvm.2025.1504671. eCollection 2025.
Amlodipine, a widely prescribed clinical medication, is associated with adverse reactions that can impede the proper execution of treatment regimens. The lack of systematic studies on amlodipine's adverse drug reactions (ADRs) necessitates further investigation to facilitate refined population management and optimize therapeutic outcomes.
This study leveraged the FDA Adverse Event Reporting System (FAERS) database, extracting reports submitted exclusively by healthcare professionals where amlodipine was designated as the primary suspect (PS). Four risk signal detection methods were employed: Ratio of Odds Ratio, Proportional Reporting Ratio, Bayesian Confidence Propagation Neural Network, and Empirical Bayes Geometric Mean, to conduct a comprehensive analysis of amlodipine-related ADRs. Furthermore, subgroup analyses stratified by gender and age were performed, with multivariable logistic regression utilized to validate the reliability of the findings.
Across the general population, male cohort, female cohort, elderly group, and younger demographic, the four signal detection methods collectively identified 513, 348, 403, 246, and 260 potential ADRs associated with amlodipine, respectively. Intersection analysis revealed 27 common ADRs, including gingival hypertrophy, vasoplegia syndrome, and distributive shock. Subsequent multivariable logistic regression confirmed amlodipine's role as an independent risk factor for all 27 ADRs (OR > 1, < 0.05).
This study provides compelling evidence that amlodipine poses risks of peripheral edema, shock, and dyspnea, among others. Additionally, it identified previously unreported ADRs such as abnormal full blood count and personality disorder. These findings underscore the importance of exercising caution when prescribing amlodipine to high-risk individuals with a history of hyperkalemia, cardiac structural abnormalities, or airway obstruction.
氨氯地平是一种广泛应用于临床的药物,会引发不良反应,可能影响治疗方案的正确实施。目前缺乏关于氨氯地平药物不良反应(ADR)的系统性研究,因此有必要进一步开展调查,以优化人群管理并提高治疗效果。
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)数据库,提取医疗保健专业人员提交的报告,其中氨氯地平被列为主要怀疑药物(PS)。采用四种风险信号检测方法:比值比(Ratio of Odds Ratio)、比例报告比(Proportional Reporting Ratio)、贝叶斯置信传播神经网络(Bayesian Confidence Propagation Neural Network)和经验贝叶斯几何均值(Empirical Bayes Geometric Mean),对与氨氯地平相关的ADR进行全面分析。此外,按性别和年龄进行亚组分析,并采用多变量逻辑回归来验证研究结果的可靠性。
在普通人群、男性队列、女性队列、老年组和年轻人群体中,四种信号检测方法分别共识别出513、348、403、246和260种与氨氯地平相关的潜在ADR。交叉分析显示有27种常见ADR,包括牙龈增生、血管麻痹综合征和分布性休克。随后的多变量逻辑回归证实氨氯地平是所有27种ADR的独立危险因素(比值比>1,P<0.05)。
本研究提供了有力证据,表明氨氯地平会引发外周水肿、休克和呼吸困难等风险。此外,还发现了如全血细胞计数异常和人格障碍等先前未报告的ADR。这些发现强调了在给有高钾血症、心脏结构异常或气道阻塞病史的高危个体开具氨氯地平时要谨慎的重要性。