非奈利酮不良反应的特征分析:来自世界卫生组织药物不良反应数据库(WHO-VigiAccess)的深入分析

Characteristic analysis of adverse reactions of finerenone: an in-depth analysis from WHO-VigiAccess.

作者信息

Fan Hongxuan, Huang Zhuolin, Yang Yafen, Li Jiahui, Zhou Boda

机构信息

Department of Cardiology, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China.

Department of Cardiology, The Second Hospital of Shanxi Medical University, Taiyuan, Shanxi, China.

出版信息

Front Pharmacol. 2025 Aug 7;16:1545148. doi: 10.3389/fphar.2025.1545148. eCollection 2025.

Abstract

INTRODUCTION

Finerenone is a novel non-steroidal mineralocorticoid receptor antagonist that has shown promise in the treatment of chronic kidney disease and heart failure. As its clinical use expands, understanding the adverse events associated with finerenone becomes crucial to ensuring patient safety. Prior pharmacovigilance studies have not systematically mapped finerenone-related AEs across all organ systems using global spontaneous-reporting data. We therefore aimed to identify and quantify these signals in the WHO-VigiAccess database.

METHODS

This study employed a retrospective descriptive analysis using the reporting odds ratio (ROR), proportional reporting ratio (PRR), bayesian confidence propagation neural network (BCPNN) and empirical bayes geometric mean (EBGM) approaches to investigate reports of AEs associated with finerenone. Data were sourced from WHO's VigiAccess database, focusing on affected organ systems, symptoms, and demographic details, such as age, gender, and geographic distribution of the patients in the reports. The VigiAccess database was queried in November 2024 to collect data on AEsreported after the administration of finerenone.

RESULTS

A total of 1,482 AEs associated with finerenone were reported in VigiAccess by the end of November 2024. The analysis identified the five most frequently reported AEs, including hyperkalaemia (N = 272, ROR = 244.39), glomerular filtration rate dereased (N = 186, ROR = 684.34), blood potassium increased (N = 141, ROR = 372.63), blood creatinine increased (N = 100, ROR = 50.89), death (N = 62, ROR = 3.28), hypotension (N = 46, ROR = 5.45). The five most common categories of AEs included investigations yielding undesirable outcomes (636 cases, 26.67%), metabolism and nutrition disorders (360 cases, 15.09%), general disorders and administration site conditions (263 cases, 11.03%), gastrointestinal disorders (211 cases, 8.85%), renal and urinary disorders (159 cases, 6.67%).

CONCLUSION

The study highlighted the significance of monitoring AEsrelated to finerenone, with 1,482 AEs reported by November 2024. While many AEs were mild and self-limiting, some were severe, potentially leading to hospitalization or serious health implications. It is imperative for healthcare systems to engage in robust safety research and monitoring to better understand the causal relationships between finerenone and reported AEs, ensuring safer therapeutic outcomes for patients.

摘要

引言

非奈利酮是一种新型非甾体类盐皮质激素受体拮抗剂,在慢性肾脏病和心力衰竭治疗中显示出前景。随着其临床应用的扩大,了解与非奈利酮相关的不良事件对于确保患者安全至关重要。既往的药物警戒研究尚未利用全球自发报告数据系统地梳理非奈利酮相关不良事件在所有器官系统中的情况。因此,我们旨在在世卫组织药物警戒数据库中识别并量化这些信号。

方法

本研究采用回顾性描述性分析,运用报告比值比(ROR)、比例报告比值比(PRR)、贝叶斯置信传播神经网络(BCPNN)和经验贝叶斯几何均值(EBGM)方法,调查与非奈利酮相关的不良事件报告。数据来源于世卫组织的药物警戒数据库,重点关注受影响的器官系统、症状以及人口统计学细节,如报告中患者的年龄、性别和地理分布。2024年11月查询了药物警戒数据库,以收集非奈利酮给药后报告的不良事件数据。

结果

截至2024年11月底,药物警戒数据库中共报告了1482例与非奈利酮相关的不良事件。分析确定了报告频率最高的五种不良事件,包括高钾血症(N = 272,ROR = 244.39)、肾小球滤过率降低(N = 186,ROR = 684.34)、血钾升高(N = 141,ROR = 372.63)、血肌酐升高(N = 100,ROR = 50.89)、死亡(N = 62,ROR = 3.28)、低血压(N = 46,ROR = 5.45)。最常见的五类不良事件包括检查结果不良(636例,26.67%)、代谢和营养紊乱(360例,15.09%)、全身紊乱和给药部位情况(263例,11.03%)、胃肠道紊乱(211例,8.85%)、肾脏和泌尿系统紊乱(159例,6.67%)。

结论

该研究强调了监测与非奈利酮相关不良事件的重要性,截至2024年11月已报告1482例不良事件。虽然许多不良事件为轻度且自限性,但有些较为严重,可能导致住院或严重健康问题。医疗系统必须开展有力的安全性研究和监测,以更好地了解非奈利酮与报告的不良事件之间的因果关系,确保为患者带来更安全的治疗结果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e087/12367681/c740a6b23f38/fphar-16-1545148-g001.jpg

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