3种静脉用溶栓药物在真实世界的药物警戒研究

    Pharmacovigilance Study of Three Intravenous Thrombolytic Drugs in the Real World

    • 摘要:
      目的  本研究通过OpenVigil药物警戒数据分析网站,分析FDA不良事件上报(FDA Adverse Event Reporting System,FAERS)数据库中注射用溶栓药物阿替普酶、替奈普酶和瑞替普酶的药品不良事件(adverse drug event,ADE)数据,通过数据挖掘,为临床合理用药提供指导,并优化患者治疗方案。
      方法 在 OpenVigil 药物警戒数据分析网站使用 OpenVigil 2.1-MedDRA-v26.1(data 2004Q1-2023Q3)在线分析系统,对FAERS的2004年第1季度—2023第3季度数据进行分析:提取首选语为“alteplase”“tenecteplase”“reteplase”的数据。然后采用了报告比值比法、综合标准法来进行阿替普酶、替奈普酶和瑞替普酶ADE的数据挖掘。使用MedDRA术语集对阳性信号进行汉化和系统器官分类。
      结果 阿替普酶和替奈普酶均出现感染性肺炎和骨筋膜室综合征的新信号,并且阿替普酶出现血管性水肿的强信号,瑞替普酶出现马-魏二氏综合征的强信号。
      结论 3种溶栓药物均有新的ADE信号,医务人员在进行溶栓治疗时,除了关注药品说明书中已有的ADE外,还应密切关注说明书中未收录但信号值较强的ADE,保证患者用药的安全性和有效性。

       

      Abstract:
      OBJECTIVE To analyze adverse drug event(ADE) data for the thrombolytic agents alteplase, tenecteplase, and reteplase(administered via injection) using the OpenVigil pharmacovigilance analysis platform to mine the FDA Adverse Event Reporting System(FAERS) database. Through systematic data mining, the findings aim to provide evidence-based guidance for clinical medication optimization and individualized treatment regimen refinement.
      METHODS This study utilized the OpenVigil 2.1-MedDRA-v26.1 (data from 2004Q1 to 2023Q3) online analysis system on the OpenVigil drug surveillance data analysis website to analyze data from the FAERS for the first quarter of 2004 through the third quarter of 2023. The analysis involved extracting data related to Preferred Terms with the names "alteplase", "tenecteplase", and "reteplase". Afterwards, the reporting odds ratio and medicines and healthcare products regulatory agency methods were employed to conduct data mining on adverse reaction reports associated with alteplase, tenecteplase, and reteplase. Translated and systematically classified positive signals using the MedDRA terminology set.
      RESULTS Both alteplase and tenecteplase exhibited new signals for infectious pneumonia and compartment syndrome, while alteplase demonstrated a strong signal for vascular edema, and reteplase displayed a strong signal for marfan syndrome.
      CONCLUSION Novel ADE signals are detected for all 3 thrombolytic agents. Clinicians should not only monitor ADEs listed in the drug labels but also remain vigilant for unlabeled yet high-signal-strength ADEs during thrombolytic therapy to ensure both patient safety and treatment efficacy.

       

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