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临床应用中环磷酰胺不良事件的分析

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目的 通过对临床应用中环磷酰胺不良事件(ADE)信息进行分析,为临床合理、安全用药提供参考.方法 基于美国药品食品监督管理局不良事件报告系统数据库(FAERS),用在线药物警戒工具OpenVigil收集环磷酰胺2013-01-01-2023-03-11的ADE数据.用比值失衡测量法中的报告比值比(ROR)法和贝叶斯置信区间递进神经网络(BCPNN)法对ADE数据进行分析.结果 符合纳入标准的ADE报告共计8 223份,得到ADE信号422个,累及21个系统器官分类(SOC),其中女性(44.12%)占比高于男性(31.02%),年龄主要分布在46~65岁的人群.累及的SOC主要包括感染及侵染类疾病、血液及淋巴系统疾病、全身性疾病及给药部位各种反应等;报告数较多的ADE信号为骨髓抑制、疾病进展、发热、发热性中性粒细胞减少症等.挖掘到18个说明书未记录的新发现可疑药物不良反应(ADR).结论 临床医务工作者在使用环磷酰胺时,应警惕药品说明书以外的ADE信号,如新生儿疾病和孕产妇在妊娠前的暴露、高铁血红蛋白血症等,以提高临床治疗的安全性和有效性.
Analysis of cyclophosphamide adverse events in clinical applications
Objective To provide clinical practitioners with references for rational and safe usage of cyclophosphamide(CTX)by conducting an in-depth analysis of its adverse drug events(ADE)reported in clinical settings.Methods Based on the Food and Drug Administration(FDA)adverse event reporting system,the online pharmacovigilance tool OpenVigil collected ADE data of CTX from January 1,2013 to March 11,2023.The ADE data mining analysis was performed using the reporting odds ratio(ROR)and Bayesian confidence propagation neural network(BCPNN)methods.Results A total of 8 223 ADE reports met the inclusion criteria,and 422 ADE signals were obtained,involving 21 system organ classification(SOC),of which women(44.12%)accounted for a higher proportion than men(31.02%),the age distribution was mainly in the population 46-65 years old.The involved SOC mainly included infections and invasive diseases,hematologic and lymphatic system diseases,systemic diseases and various reactions at the site of administration,etc.;the ADE signals with a higher number of reports were myelosuppression,disease progression,pyrexia,febrile neutropenia,etc.A total of 18 suspected adverse drug reaction(ADR)not documented in the CTX drug insert were unearthed.Conclusion Clinical practitioners should be alert to ADE signals outside the drug insert,such as neonatal diseases and maternal exposure before pregnancy,methemoglobinemia,etc.,when using cyclophosphamide to improve the safety and effectiveness of clinical treatment.

cyclophosphamideadverse drug reactionpharmacovigilanceFood and Drug Administration adverse event reporting systemsignal mining and analysis

章婉春、汪梅姣、谢志军

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浙江中医药大学 基础医学院,浙江 杭州 310000

环磷酰胺 药品不良反应 药物警戒 美国食品药品监督管理局不良事件报告系统 数据挖掘与分析

国家自然科学基金浙江省中医药科技计划

819738292020ZZ006

2024

中国临床药理学杂志
中国药学会

中国临床药理学杂志

CSTPCD北大核心
影响因子:1.91
ISSN:1001-6821
年,卷(期):2024.40(7)
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