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基于美国FAERS数据库的阿巴西普不良事件信号挖掘与分析
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| 篇名： | 基于美国FAERS数据库的阿巴西普不良事件信号挖掘与分析 |
| TITLE： | Signal mining and analysis of adverse drug events of abatacept based on FAERS database |
| 摘要： | 目的 为阿巴西普的临床安全使用提供参考依据。方法以美国FDA不良事件报告系统（FAERS）数据库为基础，以药品通用名“abatacept”与商品名“Orencia”作为检索关键词，检索首要怀疑药物为阿巴西普的药物不良事件（ADE）信号，并采用比例失衡法中的报告比值比法和比例报告比值法以及Excel2020软件对信号进行挖掘与分析。结果共检索出阿巴西普ADE报告93189份，以女性病例（75.98%）为主，年龄主要集中于18～64岁（35.17%）；数据上报的主要国家为美国（47.41%）与加拿大（30.59%），上报的数量总体呈逐年递增的趋势。共筛选出ADE信号3092个，其中与阿巴西普的药品说明书描述相似的是与原发疾病相关的ADE信号，如类风湿性关节炎、关节痛、关节肿胀等；其次是与输液反应相关的ADE信号，包括疼痛、乏力、皮疹等。所有筛选出的ADE信号共涉及27个系统器官分类，主要为全身疾病及给药部位各种反应，肌肉骨骼和结缔组织疾病，伤害、中毒和手术并发症，感染和侵袭类疾病，胃肠疾病，神经系统疾病，呼吸、胸腔和纵隔疾病，心脏疾病，良性、恶性和未特指的肿瘤，生殖系统和乳腺疾病等。报告例数排前50位的ADE信号中未被阿巴西普药品说明书收录的共有22个，包括乏力、药物不耐受、腹部不适、肿胀、红斑狼疮、周围肿胀、天疱疮、腹泻、肝酶升高与下呼吸道感染等。结论临床在使用阿巴西普的过程中应格外注意感染及其致癌性，同时评估患者的呼吸及心血管系统疾病风险，当患者合并这2类基础疾病时，应权衡利弊后谨慎选用；此外，该药在神经、胃肠及生殖系统的ADE也不容忽视。 |
| ABSTRACT： | OBJECTIVE To provide a reference for the safe use of abatacept in clinic. METHODS Based on the United States FDA Adverse Event Reporting System （FAERS） database， the generic name of the drug “abatacept” and the trade name “Orencia” were used as the search keywords to retrieve drug adverse event （ADE） signal of abatacept as primary suspected drug. The reported odds ratio method and proportional reporting ratio method in the proportional imbalance method and Excel 2020 software were used to mine and analyze the signals. RESULTS A total of 93 189 abatacept-induced ADE reports were retrieved， mainly female cases （75.98%）， and the age was mainly concentrated in 18-64 years old （35.17%）； main countries reporting data were the United States （47.41%） and Canada （30.59%）， and the number of reports was generally increasing year by year. A total of 3 092 ADE signals were screened， of which the signals associated with the primary disease were similar to those described in the drug instruction of abatacept， such as rheumatoid arthritis， arthralgia， joint swelling， etc.； followed by ADE signals related to infusion reactions， including pain， fatigue， rash， etc. All selected ADE signals involved 27 system organ classes， mainly involved systemic diseases and drug site conditions， musculoskeletal and connective tissue diseases， injury， poisoning and surgical complications， infections and invasive diseases， gastrointestinal diseases， neurological diseases， respiratory， thoracic and mediastinal diseases， heart diseases， benign， malignant and unspecified tumors and reproductive system and breast diseases， etc. A total of 22 ADE signals were not included in the drug instructions of abatacept among the top 50 ADE signals in the number list of reported cases， including fatigue， drug intolerance， abdominal discomfort， swelling， lupus erythematosus， peripheral swelling， cell sores， diarrhea， elevated liver enzymes and lower respiratory tract infection， etc. CONCLUSIONS In the process of clinical use of abatacept， special attention should be paid to infection and its carcinogenicity， while assessing the risk of respiratory and cardiovascular system diseases in patients； when patients suffer from these two underlying diseases， the pros and cons should be weighed carefully before selecting drug； in addition， the drug-induced ADE in the neurological， gastrointestinal and reproductive system cannot be ignored. |
| 期刊： | 2023年第34卷第15期 |
| 作者： | 高茂威；杨小娟；纵尚尚 |
| AUTHORS： | GAO Maowei，YANG Xiaojuan，ZONG Shangshang |
| 关键字： | 阿巴西普；药物不良事件；数据挖掘；药物不良反应；比例失衡法 |
| KEYWORDS： | abatacept； adverse drug events； data mining； |
| 阅读数： | 157 次 |
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