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与依列卡福妥/替扎卡福妥/依伐卡福妥治疗相关的不良事件和药物相互作用:一项横跨澳大利亚、加拿大和美国不良事件数据库的描述性研究。

Adverse Events and Drug Interactions Associated with Elexacaftor/Tezacaftor/Ivacaftor Treatment: A Descriptive Study Across Australian, Canadian, and American Adverse Event Databases.

作者信息

Thiruchelvam Theeba, Lim Chiao Xin, Munro Courtney, Chan Vincent, Jayasuria Geshani, Coulthard Kingsley P, Wark Peter A B, Suppiah Vijayaprakash

机构信息

Discipline of Pharmacy, School of Health and Biomedical Sciences, RMIT University, Bundoora, VIC 3083, Australia.

John Hunter Hospital, Newcastle, NSW 2305, Australia.

出版信息

Life (Basel). 2025 Aug 7;15(8):1256. doi: 10.3390/life15081256.

DOI:10.3390/life15081256
PMID:40868904
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12387162/
Abstract

People with cystic fibrosis may experience polypharmacy, which can increase the risk of drug induced complications such as adverse events and drug-drug interactions. This study aimed to examine the prevalence of adverse events and to identify potential drug-drug interactions associated with elexacaftor/tezacaftor/ivacaftor (ETI). Three databases, the Australian Therapeutic Goods Administration Database of Adverse Event Notification (TGA DAEN), the Canada Vigilance Adverse Reaction Online Database (CVAROD), and the USA Food and Drug Administration Adverse Event Reporting System (FAERS) Database were searched for spontaneous ETI adverse events between 2019 and 2024. Descriptive analysis of the data was undertaken. The FAERS database was analysed to identify adverse events of interest such as anxiety and depression and concomitant drugs prescribed with ETI. A total of 10,628 ETI associated adverse events were identified in all system organ classes. The incidence of psychiatric adverse events ranged from 7 to 15% across the three databases. Potential drug-drug interactions with CYP 3A4/5 strong inhibitors and strong inducers were identified from the FAERS database and azole antifungals were implicated in several ETI dose modifications. The prevalence and types of ETI adverse events were varied and use of concomitant drugs with potential drug interactions was significant, requiring more research to manage them.

摘要

患有囊性纤维化的人可能会使用多种药物,这会增加药物引起的并发症风险,如不良事件和药物相互作用。本研究旨在调查不良事件的发生率,并确定与依列卡福/替扎卡福/依伐卡福(ETI)相关的潜在药物相互作用。检索了三个数据库,即澳大利亚治疗用品管理局不良事件通报数据库(TGA DAEN)、加拿大警戒不良反应在线数据库(CVAROD)和美国食品药品监督管理局不良事件报告系统(FAERS)数据库,以查找2019年至2024年期间ETI的自发不良事件。对数据进行了描述性分析。对FAERS数据库进行分析,以确定感兴趣的不良事件,如焦虑和抑郁,以及与ETI同时开具的药物。在所有系统器官类别中,共识别出10628例与ETI相关的不良事件。三个数据库中精神科不良事件的发生率在7%至15%之间。从FAERS数据库中识别出与CYP 3A4/5强抑制剂和强诱导剂的潜在药物相互作用,并且唑类抗真菌药物与几种ETI剂量调整有关。ETI不良事件的发生率和类型各不相同,同时使用具有潜在药物相互作用的药物的情况很显著,需要更多研究来管理这些情况。

相似文献

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Adverse Events and Drug Interactions Associated with Elexacaftor/Tezacaftor/Ivacaftor Treatment: A Descriptive Study Across Australian, Canadian, and American Adverse Event Databases.与依列卡福妥/替扎卡福妥/依伐卡福妥治疗相关的不良事件和药物相互作用:一项横跨澳大利亚、加拿大和美国不良事件数据库的描述性研究。
Life (Basel). 2025 Aug 7;15(8):1256. doi: 10.3390/life15081256.
2
Evaluation of elexacaftor-tezacaftor-ivacaftor treatment in individuals with cystic fibrosis and CFTR in the USA: a prospective, multicentre, open-label, single-arm trial.在美国对患有囊性纤维化和CFTR的个体进行的依列卡福托-替扎卡福托-依伐卡托治疗评估:一项前瞻性、多中心、开放标签、单臂试验。
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Cochrane Database Syst Rev. 2023 Nov 20;11(11):CD010966. doi: 10.1002/14651858.CD010966.pub4.
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本文引用的文献

1
Pharmacovigilance in Australia: how do adverse event reports from clinicians contribute to medicine and vaccine safety?澳大利亚的药物警戒:临床医生提交的不良事件报告如何促进药品和疫苗安全?
Aust Prescr. 2024 Dec;47(6):186-191. doi: 10.18773/austprescr.2024.056.
2
Heterogeneity in Reported Side Effects Following Initiation of Elexacaftor-Tezacaftor-Ivacaftor: Experiences at a Quaternary CF Care Center.艾力沙卡托-替扎卡托-依伐卡托起始治疗后报告的副作用的异质性:一家四级囊性纤维化护理中心的经验。
Pediatr Pulmonol. 2025 Jan;60(1):e27382. doi: 10.1002/ppul.27382. Epub 2024 Nov 6.
3
Reported Adverse Events in a Multicenter Cohort of Patients Ages 6-18 Years with Cystic Fibrosis and at Least One F508del Allele Receiving Elexacaftor/Tezacaftor/Ivacaftor.在一个多中心队列中,年龄6至18岁、患有囊性纤维化且至少有一个F508del等位基因的患者接受依列卡福/替扎卡福/依伐卡福治疗时报告的不良事件。
J Pediatr. 2024 Nov;274:114176. doi: 10.1016/j.jpeds.2024.114176. Epub 2024 Jun 28.
4
Limitations of randomised controlled trials as evidence of drug safety.随机对照试验作为药物安全性证据的局限性。
Aust Prescr. 2023 Aug;46(2):22-23. doi: 10.18773/austprescr.2023.005.
5
Prevalence of adverse events in cystic fibrosis patients treated with elexacaftor/tezacaftor/ivacaftor: Experience of the regional referral center in Tuscany, Italy.接受依列卡福妥/替扎卡福妥/依伐卡托治疗的囊性纤维化患者不良事件的发生率:意大利托斯卡纳地区转诊中心的经验
Pediatr Pulmonol. 2023 Dec;58(12):3626-3629. doi: 10.1002/ppul.26673. Epub 2023 Sep 26.
6
Neuropsychiatric adverse effects from CFTR modulators deserve a serious research effort.CFTR 调节剂所致神经精神不良事件值得深入研究。
Curr Opin Pulm Med. 2023 Nov 1;29(6):603-609. doi: 10.1097/MCP.0000000000001014. Epub 2023 Sep 1.
7
Cystic Fibrosis: A Review.囊性纤维化:综述。
JAMA. 2023 Jun 6;329(21):1859-1871. doi: 10.1001/jama.2023.8120.
8
Drug-drug interactions involving CFTR modulators: a review of the evidence and clinical implications.涉及 CFTR 调节剂的药物相互作用:证据回顾与临床意义。
Expert Opin Drug Metab Toxicol. 2023 Apr;19(4):203-216. doi: 10.1080/17425255.2023.2220960. Epub 2023 Jun 6.
9
Individualized approach to elexacaftor/tezacaftor/ivacaftor dosing in cystic fibrosis, in response to self-reported anxiety and neurocognitive adverse events: A case series.针对囊性纤维化患者,根据自我报告的焦虑和神经认知不良事件,采用个体化方法调整依列卡福/替扎卡福/依伐卡托剂量:病例系列
Front Pharmacol. 2023 Apr 27;14:1156621. doi: 10.3389/fphar.2023.1156621. eCollection 2023.
10
Management of neuropsychiatric symptoms in adults treated with elexacaftor/tezacaftor/ivacaftor.依伐卡托与泰它卡托和艾乐卡托联合治疗成人的神经精神症状管理。
Pediatr Pulmonol. 2023 Jul;58(7):1920-1930. doi: 10.1002/ppul.26412. Epub 2023 Apr 10.