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中国临床药理学与治疗学 ›› 2024, Vol. 29 ›› Issue (7): 752-761.doi: 10.12092/j.issn.1009-2501.2024.07.004

• 生物类似药研发与临床个体化使用最新进展 • 上一篇    下一篇

基于FAERS数据库的维泊妥珠单抗不良反应信号挖掘

宋再伟1,2,3,李欣亚2,3,门  鹏2,3,姜  丹2,3,董  菲4,赵荣生2,3,杨  珺1   

  1. 1国家癌症中心·国家肿瘤临床医学研究中心·中国医学科学院北京协和医学院肿瘤医院药剂科,北京  100021;
    2北京大学第三医院药学部,北京  100191;
    3北京大学医学部药物评价中心,北京  100191;
    4北京大学第三医院血液科,北京  100191

  • 收稿日期:2023-08-14 修回日期:2024-01-22 出版日期:2024-07-26 发布日期:2024-06-24
  • 通讯作者: 杨珺,女,硕士,主任药师,研究方向:肿瘤临床药学。 E-mail: yangjun_99@126.com
  • 基金资助:
    北京市卫生健康科技成果和适宜技术推广项目(BHTPP2022079)

Signal mining and analysis of adverse drug reactions for polatuzumab vedotin based on FAERS database

SONG Zaiwei1,2,3, LI Xinya2,3, MEN Peng2,3, JIANG Dan2,3, DONG Fei4, ZHAO Rongsheng2,3, YANG Jun1   

  1. 1 Department of Pharmacy, National Cancer Center, National Clinical Research Center for Cancer, Cancer Hospital of Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China; 2 Department of Pharmacy, Peking University Third Hospital, Beijing 100191, China; 3 Institute for Drug Evaluation, Peking University Health Science Center, Beijing 100191, China; 4 Department of hematology, Peking University Third Hospital, Beijing 100191, China
  • Received:2023-08-14 Revised:2024-01-22 Online:2024-07-26 Published:2024-06-24
  • About author:宋再伟,男,硕士,主管药师,研究方向:循证药学、治疗药物监测。 E-mail: songzw445@126.com

摘要:

目的:评价和分析维泊妥珠单抗上市后的药物不良反应(adverse drug reaction,ADR)信号,为临床安全性管理提供参考。方法:通过开放性OpenVigil数据平台,收集2019年6月10日(美国FDA批准上市时间)至2023年3月31日美国FDA不良事件报告系统(FAERS)数据库中维泊妥珠单抗的ADR报告。采用比例失衡法中的报告比值比(ROR)和比例报告比(PRR)进行信号挖掘。为提高阈值,得到信号较强、较常出现的ADR,将信号进行二次筛选。结果:共检索到维泊妥珠单抗相关ADR报告2 408份,经过二次筛选得到83个ADR信号。其中,脊柱磁共振成像异常、骨吸收增加、骨质溶解、天门冬氨酸氨基转移酶降低、丙氨酸氨基转移酶降低、低纤维蛋白原血症、肺栓塞等26个ADR信号在药品说明书中未提及。信号数或累积例数较多的系统器官分类包含感染及侵染类疾病(24个信号、632例),各类检查(17个信号、675例),血液及淋巴系统疾病(11个信号、734例),各类神经系统疾病(7个信号、153例),免疫系统疾病(3个信号、95例),全身性疾病及给药部位各种反应(2个信号、145例),代谢及营养类疾病(2个信号、87例)等。结论:除说明书提示的常见ADR外,本研究发现了维泊妥珠单抗新的ADR风险信号。建议临床在关注感染、骨髓抑制、周围神经病、输液相关反应、肝功能异常等已知常见ADR的同时,予以脊柱磁共振成像异常、骨吸收增加等新的风险信号更多关注。

关键词: 维泊妥珠单抗, 弥漫大B细胞淋巴瘤, 不良反应, 美国食品药品监督管理局药物不良事件报告系统, 信号挖掘

Abstract:

AIM: To evaluate and analyze the post-marketing adverse drug reaction (ADR) signals of polatuzumab vedotin, so as to provide reference for clinical safety management. METHODS: Using the FDA adverse drug event reporting system (FAERS) database and OpenVigil data platform, the ADR reports of polatuzumab vedotin were collected from June 10, 2019 (FDA approval for marketing) to the March 31, 2023. The ADR signals were detected by using the reporting odds ratio (ROR) and proportional reporting ratio (PRR) in the proportional imbalance method. To increase the threshold and obtain stronger and more frequently occurring ADRs, a second screening of signals was performed. RESULTS: A total of 2 408 ADR reports related to polatuzumab vedotin were collected, and 83 ADR signals were detected after secondary screening. 26 ADR signals were not mentioned in the drug instructions such as abnormal spinal magnetic resonance imaging, increased bone resorption, osteolysis, decreased aspartate aminotransferase, decreased alanine aminotransferase, hypofibrinogenemia, and pulmonary embolism. The system organ classes with a high signal counts or cumulative number of cases included infections and invasive diseases (24 signals, 632 cases), various examinations (17 signals, 675 cases), blood and lymphatic system diseases (11 signals, 734 cases), various nervous system diseases (7 signals, 153 cases), immune system diseases (3 signals, 95 cases), systemic diseases and various reactions at the site of administration (2 signals, 145 cases), and systemic diseases and various reactions at the site of administration (2 signals, 87 cases), etc. CONCLUSION: In addition to the common ADRs suggested by the instructions, this study identified new ADR risk signals for polatuzumab vedotin. In the clinical application of polatuzumab vedotin, in addition to the ADR mentioned in the instructions such as infections, myelosuppression, peripheral neuropathies, infusion-related reactions, and abnormal liver function, attention should also be paid to the risk signals not mentioned such as abnormal spinal magnetic resonance imaging, and increased bone resorption.

Key words: polatuzumab vedotin, diffuse large B-cell lymphoma, adverse drug reaction, FDA adverse drug event reporting system, signal mining

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