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印度一家三级护理医院对小儿地中海贫血患者使用品牌仿制药地拉罗司进行靶向主动监测:一项药物警戒研究。

Targeted active surveillance of branded generic deferasirox in pediatric thalassemia patients in a tertiary care hospital of India: A pharmacovigilance study.

作者信息

Panigrahi Mousumee, Swain Trupti Rekha, Jena Rabindra Kumar, Panigrahi Ashutosh, Debta Nishant

机构信息

Department of Pharmacology, AIIMS, Gorakhpur, Uttar Pradesh, India.

Department of Pharmacology, S.C.B. Medical College, Cuttack, Odisha, India.

出版信息

Indian J Pharmacol. 2025 Mar 1;57(2):77-82. doi: 10.4103/ijp.ijp_88_23. Epub 2025 Jun 13.

Abstract

INTRODUCTION

Deferasirox is a newer oral iron chelator which needs to be given for at least 1 year to see a significant decrease in serum ferritin level in thalassemia patients with chronic iron overload. This study aimed to assess the safety profile of branded generic deferasirox in pediatric thalassemia cases, as it has not been studied in eastern India, especially in real-world settings.

SUBJECTS AND METHODS

It was an observational hospital-based study in a government tertiary care teaching hospital where branded generic deferasirox is distributed free of cost to patients. One hundred and seventy-four patients were included. Safety assessment was done through active questioning about the symptoms starting after deferasirox therapy and through laboratory parameters and clinical examination.

RESULTS

Sixty percent of patients developed adverse drug reactions (ADRs) with deferasirox during the 1-year follow-up. ADRs were more common in males than females. The highest number of ADRs was related to the gastrointestinal and hepatobiliary system. The ADRs were either mild or moderate. Compliance and number of ADRs were found to be inversely correlated.

CONCLUSION

ADRs of deferasirox are acceptable looking at the benefits. Regular monitoring and management of ADRs will facilitate patient compliance. However, healthcare professionals need to be alert while prescribing this drug and report any ADR, even if it is not labeled. This study found increased serum lipase and mouth ulcer as adverse effects, which are not yet labeled. These can be signals for further analysis by regulatory authorities.

摘要

引言

地拉罗司是一种较新的口服铁螯合剂,对于慢性铁过载的地中海贫血患者,需要服用至少1年才能使血清铁蛋白水平显著下降。本研究旨在评估品牌通用型地拉罗司在儿童地中海贫血病例中的安全性,因为在印度东部尚未对其进行研究,尤其是在实际临床环境中。

研究对象与方法

这是一项在政府三级医疗教学医院开展的基于医院的观察性研究,在该医院品牌通用型地拉罗司免费分发给患者。共纳入174例患者。通过主动询问地拉罗司治疗开始后的症状、实验室参数及临床检查进行安全性评估。

结果

在1年的随访期间,60%的患者使用地拉罗司后出现药物不良反应(ADR)。ADR在男性中比女性更常见。ADR数量最多的与胃肠道和肝胆系统有关。这些ADR为轻度或中度。发现依从性与ADR数量呈负相关。

结论

考虑到益处,地拉罗司的ADR是可以接受的。对ADR进行定期监测和管理将有助于提高患者依从性。然而,医疗保健专业人员在开具此药时需要保持警惕,并报告任何ADR,即使它未被标注。本研究发现血清脂肪酶升高和口腔溃疡为不良反应,尚未被标注。这些可能是监管机构进一步分析的信号。

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