RESUMEN
OBJECTIVE To mine and analyze the post-marketing adverse drug event (ADE) signals of irinotecan in adults and children populations, and to provide a reference for clinical safe medication. METHODS ADE reports of irinotecan from the first quarter of 2004 to the first quarter of 2023 in the US FDA adverse event reporting system database were extracted and the risk signals of irinotecan were detected through the reporting odds ratio and proportional reporting ratio. Statistical analysis was performed for ADE reports and signals of patients aged<18 years (children) and ≥18 years (adults). RESULTS A total of 8 013 ADE reports with irinotecan as the primary suspect drug were identified, including 7 656 and 357 ADE reports in adults and children, respectively. A total of 518 and 75 ADE signals were detected in the adults and children, and the mainly involved systems and organs including gastrointestinal disorders, blood and lymphatic system disorders, systemic disorders and various reactions at the administration site, etc. Most of the top 20 ADE signals in terms of frequency were documented in the drug instructions of irinotecan. New ADE signals in adults included peripheral neuropathy, oral mucosal inflammation, pulmonary embolism, epidermal nevus syndrome and reproductive toxicity, while hypertension, progressive neoplasms, tumor lysis syndromes, and embolism were new ADE signals in children. CONCLUSIONS The above new suspected high-risk signals not mentioned in the instructions should raise a high level of alertness in clinical practice of irinotecan.
RESUMEN
OBJECTIVE To mine and analyze the post-marketing adverse drug event (ADE) signals of irinotecan in adults and children populations, and to provide a reference for clinical safe medication. METHODS ADE reports of irinotecan from the first quarter of 2004 to the first quarter of 2023 in the US FDA adverse event reporting system database were extracted and the risk signals of irinotecan were detected through the reporting odds ratio and proportional reporting ratio. Statistical analysis was performed for ADE reports and signals of patients aged<18 years (children) and ≥18 years (adults). RESULTS A total of 8 013 ADE reports with irinotecan as the primary suspect drug were identified, including 7 656 and 357 ADE reports in adults and children, respectively. A total of 518 and 75 ADE signals were detected in the adults and children, and the mainly involved systems and organs including gastrointestinal disorders, blood and lymphatic system disorders, systemic disorders and various reactions at the administration site, etc. Most of the top 20 ADE signals in terms of frequency were documented in the drug instructions of irinotecan. New ADE signals in adults included peripheral neuropathy, oral mucosal inflammation, pulmonary embolism, epidermal nevus syndrome and reproductive toxicity, while hypertension, progressive neoplasms, tumor lysis syndromes, and embolism were new ADE signals in children. CONCLUSIONS The above new suspected high-risk signals not mentioned in the instructions should raise a high level of alertness in clinical practice of irinotecan.
RESUMEN
OBJECTIVE To explore the risk signals of Fluocinolone acetonide intravitreal implants and promote safe and rational drug use for patients. METHODS Based on the data from the Hainan Province Franchised Drug Adverse Reaction Monitoring Subsystem (hereinafter referred to as the “Franchised Drug Monitoring System”) and the FDA Adverse Event Reporting System (FAERS), the adverse drug reaction (ADR)/adverse drug event (ADE) reports of Fluocinolone acetonide intravitreal implants were coded by using system organ classification and preferred terminology, and relevant patient information was collected. Risk signal mining was carried out by using the reporting odds ratio (ROR) method and the comprehensive standards method of the UK Medicines and Healthcare Products Regulatory Agency (hereinafter referred to as the “MHRA method”). RESULTS Among the 72 reports of Fluocinolone acetonide intravitreal implants received by the Franchised Drug Monitoring System, the ratio of male to female was 1∶1.4, the patient’s age was mainly distributed between 18 and 64 years old; ADR/ADE affected 5 systemic organs, with eye organ diseases accounting for 87.7%; among them, there were 9 new and general ADR reports (12.5%) and 4 severe ADR reports (5.6%); ROR method and MHRA method both identified three risk signals: cataracts, glaucoma, and high intraocular pressure. Among the 244 reports received by the FAERS database, the ratio of male to female was 1∶1.5; ADR/ADE damage affected 10 systemic organs, with 46.1% suffering from various injuries, poisoning, and operational complications, and 32.0% suffering from product problems; there were 20 severe ADR reports (8.2%); ROR method and MHRA method both identified 19 risk signals, including implantation complications, medication system issues, etc. CONCLUSIONS When using Fluocinolone acetonide intravitreal implants in clinical practice, in addition to paying attention to eye ADR/ADE such as high intraocular pressure, cataracts, and glaucoma, attention should also be paid to the potential risks caused by ADE due to product quality and unreasonable use.
RESUMEN
To explore the general characteristics of adverse drug reactions/adverse events(ADR/AE) in patients after using Shujin Jianyao Pills, and explore risk warning signals, this study analyzed 166 cases of ADR/AE reports of Shujin Jianyao Pills collected from 2005 to 2017 based on the National Center for ADR Monitoring spontaneous reporting system(SRS). And the descriptive statistical method was used to analyze general characteristics. The results showed that among the 166 ADR/AE cases, 106 cases were female patients, accounting for 63.86%. Middle-aged and elderly people aged 45 to 64 accounted for the largest proportion(82 cases, 49.40%), which were followed by elderly aged 65 and over(48 cases, 28.91%). ADR/AE involved a wide range of systems and organs, of which skin and its accessories were the most damaged(30 cases, 12.93%), which were followed by systemic damage(27 cases, 11.64%). The top 10 ADR/AE manifestations were rash(15 cases, 6.33%), nausea(14 cases, 5.91%), dizziness(14 cases, 5.91%), abdominal pain(12 cases, 5.06%), pruritus(11 cases, 4.64%), low back pain(11 cases, 4.64%), vomiting(10 cases, 4.22%), hepatocyte damage(9 cases, 3.80%), headache(9 cases, 3.80%), and diarrhea(7 cases, 2.95%). Bayesian confidence propagation neural network(BCPNN) was used to mine the ADR/AE risk early warning signal of Shujin Jianyao Pills, and the propensity score method was used to control the balance of confounding factors. The results suggested warning signs for nausea, diarrhea, rash, and dizziness, vomiting, abdominal pain, headache, liver cell damage. This study provides a basis for the post-marke-ting safety evaluation of Shujin Jianyao Pills, and can provide guidance for its rational clinical use and risk management.
Asunto(s)
Anciano , Femenino , Humanos , Persona de Mediana Edad , Sistemas de Registro de Reacción Adversa a Medicamentos , Teorema de Bayes , Efectos Colaterales y Reacciones Adversas Relacionados con Medicamentos , Medicamentos Herbarios Chinos , Farmacovigilancia , Gestión de RiesgosRESUMEN
We present the final results of a study using the IRDI (Clinical Risk Indicators in child Development). Based on a psychoanalytic approach, 31 risk signs for child development were constructed and applied to 726 children between the ages of 0 and 18 months. One sub-sample was evaluated at the age of three. The results showed a predictive capacity of IRDIs to indicate developmental problems; 15 indicators for the IRDI were also highlighted that predict psychic risk for the constitution of the subject.
No presente artigo, apresentam-se os resultados finais da Pesquisa IRFI. A partir da psicanálise, 31 indicadores clínicos de risco para o desenvolvimento infantil (IRDI) foram construídos e aplicados em 726 crianças entre 0 e 18 meses. Uma sub-amostra foi avaliada com a idade de 3 anos. Os resultados apontaram a capacidade dos IRDI para predizer problemas de desenvolvimento e destacaram ainda 15 indicadores do IRDI com capacidade para predizer risco psíquico para a constituição subjetiva.
El presente artículo presenta los resultados finales de la pesquisa IRDI. Desde el psicoanálisis, 31 signos de riesgo para el desarrollo infantil (IRDI) se han construido y aplicado a 726 niños entre 0 y 18 meses. Se evaluó una sub nuestra a los 3 años de edad. Los resultados muestran que los IRDI poseen una capacidad de predecir problemas de desarrollo 15 signos muestran una capacidad de predicción de riesgo psíquico para la constitución subjetiva.
Cet article présente les résultats de la recherche IRDI. A partir de la psychanalyse, 31 signes cliniques de risque pour le développement de l´enfant (IRDI) ont été développés et appliqués à 726 enfants à l'âge entre 0 et 18 mois. Un sous-échantillon a été évalué à l´âge de trois ans. Les résultats ont montré que les IRDI ont la capacité de prédire des problèmes de développement. Un groupe de 15 signes prévoit d'ailleurs le risque psychique de la constitution subjective.