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替诺福韦艾拉酚胺(TAF)的真实世界不成比例性分析:美国食品药品监督管理局不良事件报告系统(FAERS)的数据挖掘

A real-world disproportionality analysis of Tenofovir Alafenamide (TAF): Data mining of the FDA adverse event reporting system (FAERS).

作者信息

Zhang Chao, Wen Jiaqi, Li Yinghui

机构信息

Linfen Central Hospital, Linfen, China.

Hepatobiliary Surgery Department, Linfen Central Hospital, Linfen, China.

出版信息

PLoS One. 2025 Jun 5;20(6):e0324675. doi: 10.1371/journal.pone.0324675. eCollection 2025.

Abstract

OBJECTS

Tenofovir Alafenamide (TAF) is a novel antiviral drug approved for the treatment of hepatitis B virus (HBV) infection. Our research objective was to evaluate the safety characteristics of TAF in practical settings by analyzing data from the FDA adverse event reporting system (FAERS) database maintained by the Food and Drug Administration (FDA).

METHOD

In our investigation, we examined the uneven distribution of adverse events associated with TAF by employing statistical metrics including the Reporting Odds Ratio (ROR), Proportional Reporting Ratio (PRR), Bayesian Confidence Propagation Neural Network (BCPNN), and Gamma-Poisson Shrinker (GPS) to determine their significance.

RESULTS

Out of the 57692002 case reports in the FAERS database, 1911 reported TAF as a major suspected (PS) adverse events (AEs). A disproportionate analysis identified 43 preferred terms (PTs) related to TAF. It is worth noting that we have observed unexpected significant adverse events, such as cerebral infarction, bone pain, swallowing difficulties, drug resistance, dementia, etc., which are not mentioned in the drug instructions.

CONCLUSION

These findings unearth novel neurological, metabolic, and resistance - related risks, thereby necessitating a marked increase in clinical vigilance. The identification of signals related to cerebral infarction and dementia implies potential vascular/metabolic interplay, highlighting the importance of lipid monitoring among long - term tenofovir alafenamide (TAF) users. In response, healthcare providers should prioritize strengthening the monitoring of neurological symptoms and lipid profiles, reevaluating bone health assessment and management protocols especially in high - risk populations, and providing support to enhance patient adherence to mitigate resistance risks. This analysis offers crucial post - marketing evidence, which is instrumental in optimizing the risk - benefit balance of TAF in the long - term management of chronic hepatitis B virus (HBV) infection.

摘要

目的

替诺福韦艾拉酚胺(TAF)是一种被批准用于治疗乙型肝炎病毒(HBV)感染的新型抗病毒药物。我们的研究目的是通过分析美国食品药品监督管理局(FDA)维护的FDA不良事件报告系统(FAERS)数据库中的数据,评估TAF在实际应用中的安全性特征。

方法

在我们的调查中,我们采用报告比值比(ROR)、比例报告比值比(PRR)、贝叶斯置信传播神经网络(BCPNN)和伽马-泊松收缩器(GPS)等统计指标来检查与TAF相关的不良事件的不均衡分布,以确定其显著性。

结果

在FAERS数据库的57692002例病例报告中,有1911例报告TAF为主要可疑(PS)不良事件(AE)。一项不成比例分析确定了43个与TAF相关的首选术语(PT)。值得注意的是,我们观察到了意外的重大不良事件,如脑梗死、骨痛、吞咽困难、耐药性、痴呆等,这些在药品说明书中未提及。

结论

这些发现揭示了新的神经、代谢和耐药相关风险,因此需要显著提高临床警惕性。与脑梗死和痴呆相关信号的识别意味着潜在的血管/代谢相互作用,突出了对长期使用替诺福韦艾拉酚胺(TAF)的患者进行血脂监测的重要性。作为应对措施,医疗保健提供者应优先加强对神经症状和血脂谱的监测,特别是在高危人群中重新评估骨骼健康评估和管理方案,并提供支持以提高患者依从性,以降低耐药风险。该分析提供了关键的上市后证据,有助于在慢性乙型肝炎病毒(HBV)感染的长期管理中优化TAF的风险效益平衡。

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