中国药物警戒 ›› 2023, Vol. 20 ›› Issue (3): 321-325.
DOI: 10.19803/j.1672-8629.20220415

• 安全与合理用药 • 上一篇    下一篇

基于FAERS 数据库舒更葡糖逆转神经肌肉阻滞安全性研究

叶培1, 张鹤巍2, 吕强3, 叶小飞2, 许金芳2, 郭晓晶2,*   

  1. 1复旦大学附属华东医院麻醉科,上海 200040;
    2海军军医大学卫生勤务学系军队卫生统计学教研室,上海 200433;
    3解放军92608部队医院麻醉科,上海 200940
  • 收稿日期:2022-07-15 出版日期:2023-03-15 发布日期:2023-03-17
  • 通讯作者: * 郭晓晶,女,博士,副教授,药物流行病学。E-mail:guoxiaojing1003@163.com
  • 作者简介:叶培,男,硕士,临床合理用药。
  • 基金资助:
    国家自然科学基金资助项目(82073671、81703296); 上海市公共卫生体系建设三年行动计划学科带头人计划(GWV-10.2-XD22); 上海市卫生和计划生育委员会优秀青年医学人才培养计划(2018YQ47); 上海市公共卫生体系建设三年行动计划优青计划(GWV-10.2-YQ33)

Safety of sugammadex for reversal of neuromuscular block based on FAERS database

YE Pei1, ZHANG Hewei2, LYU Qiang3, YE Xiaofei2, XU Jinfang2, GUO Xiaojing2,*   

  1. 1Department of Anaesthesiology, Huadong Hospital Affiliated to Fudan University, Shanghai 200040, China;
    2Department of Health Statistics, Faculty of Health Service, Naval Medical University, Shanghai 200433, China;
    3Department of Anaesthesia, Hospital 92608 of PLA, Shanghai 200940, China
  • Received:2022-07-15 Online:2023-03-15 Published:2023-03-17

摘要: 目的 基于美国食品药品监督管理局(FDA)不良事件报告系统(FAERS)数据库挖掘舒更葡糖导致的可疑不良事件信号,为临床合理用药提供参考。方法 利用不相称测定分析法中的报告比值比法(ROR)对FAERS自2012年1月1日至2022年3月31日的数据进行信号检测。结果 共获得1 379条以舒更葡糖为首要怀疑药物的不良事件记录,基于ROR法共获得130个可疑不良事件信号。其中信号强度较高的有神经肌肉阻滞复发(n=58,ROR025: 79.67)、支气管痉挛(n=123,ROR025: 71.47)、速发过敏反应(n=192,ROR025: 44.47)、心动过缓(n=177,ROR025: 38.32)、速发过敏反应性休克(n=85,ROR025: 35.48)等。不同年龄组患者使用舒更葡糖后的常见不良事件类型不相同,0~17岁组不良事件信号总体强度最低。结论 舒更葡糖相关不良事件主要涉及呼吸、心血管、免疫等系统,其中过敏性不良事件及心律失常与舒更葡糖的关联性较强,麻醉医生在使用该药物时应常规监测神经肌肉功能,并进行心电监护及血流动力学监测。

关键词: 舒更葡糖, 美国食品药品监督管理局, 不良事件报告系统, 不良事件, 信号挖掘, 神经肌肉阻滞逆转, 药物警戒

Abstract: Objective To retrieve the signals of suspected adverse events caused by sugammadex based on the U.S. Food and Drug Administration (FDA) Adverse Event Reporting System (FAERS) database so as to provide reference for clinical rational drug use. Methods The signals were detected using the ROR method in the disproportionality assay analysis of FAERS data collected from January 1, 2012 to March 31, 2022. Results A total of 1 379 records of adverse events associated with sugammadex were detected, and a total of 130 suspected adverse event signals were detected based on the ROR method. Recurrence of neuromuscular blockade (n=58,ROR025: 79.67), bronchospasm (n=123,ROR025: 71.47), anaphylactic reactions (n=192,ROR025: 44.47), bradycardia (n=177,ROR025: 38.32) and anaphylactic shock (n=85,ROR025: 35.48) had higher signal intensities. The common adverse events following the use of sugammadex in patients of different age groups varied, and the overall intensity of adverse event signals was lower in the group aged 0 to 17. Conclusion Adverse events related to sugammadex mainly involve respiratory, cardiovascular and immune systems. Among other things, allergic events and arrhythmia are strongly associated with sugammadex. Anesthesiologists should routinely monitor neuromuscular function, ECG and hemodynamics when using sugammadex.

Key words: sugammadex, FDA, FAERS, adverse event, signal mining, neuromuscular block reversal, pharmacovigilance

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