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Effects of Electronic Cigarette Use on Cardiovascular-Disease-Related Inflammatory Biomarkers in Smokers with HIV in a Switching Study in the United States 在美国的一项转换研究中,电子烟使用对HIV吸烟者心血管疾病相关炎症生物标志物的影响
Pub Date : 2023-03-21 DOI: 10.3390/pharma2010010
P. Cioe, William V. Lechner, J. Tidey, C. Kahler
People with HIV (PWH) experience higher rates of cardiovascular events (CVEs) compared with the general population. A substantial body of evidence supports that select biomarkers of inflammation (soluble CD14 [sCD14], soluble CD163 [sCD163], highly sensitive C-reactive protein [hs-CRP], interleukin-6 [IL-6]) and coagulation (D-dimer) are elevated in PWH and related to increased rates of CVEs. Our previous work showed that smoking compared with nonsmoking was associated with significantly elevated sCD14, a biomarker of monocyte activation. We aimed to explore the effect of electronic cigarette (EC) provision on inflammatory biomarkers in PWH who smoked daily and then switched to an EC. Nineteen PWH were enrolled in a pilot study in which an EC and e-liquid were provided weekly for 8 weeks. Blood specimens for inflammatory biomarker analysis were obtained at baseline (BL) and at week 8. Biomarker levels were high at BL and did not differ significantly at week 8. There were small nonsignificant reductions in sCD163 and CRP levels. Non-significant increases in IL-6, D-dimer, and sCD14 levels were also noted. Use of ECs for 8 weeks does not appear to significantly increase or decrease inflammatory biomarker levels in SWH. Further research with larger samples and a control group is needed.
与普通人群相比,艾滋病毒感染者的心血管事件发生率更高。大量证据支持,PWH中炎症的选定生物标志物(可溶性CD14[sCD14]、可溶性CD163[sCD163]、高敏C反应蛋白[hs-CRP]、白细胞介素-6[IL-6])和凝血(D-二聚体)升高,并与CVE发生率增加有关。我们之前的研究表明,与不吸烟相比,吸烟与单核细胞活化的生物标志物sCD14显著升高有关。我们旨在探讨电子烟(EC)对每天吸烟然后改用EC的PWH炎症生物标志物的影响。19名PWH参加了一项试点研究,在该研究中,每周提供EC和电子液体,为期8周。在基线(BL)和第8周获得用于炎症生物标志物分析的血样。生物标志物水平在BL时很高,并且在第8周没有显著差异。sCD163和CRP水平有轻微但不显著的降低。IL-6、D-二聚体和sCD14水平也没有显著增加。使用ECs 8周似乎不会显著增加或降低SWH中的炎症生物标志物水平。需要对更大的样本和对照组进行进一步的研究。
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引用次数: 0
Absolute Risk Reductions in COVID-19 Antiviral Medication Clinical Trials COVID-19抗病毒药物临床试验的绝对风险降低
Pub Date : 2023-03-20 DOI: 10.3390/pharma2010009
Ronald B. Brown
COVID-19 antiviral medications approved or authorized for emergency use by the U.S. Food and Drug Administration are reported to have high efficacy in preventing severe illness, hospitalizations, and deaths. However, reports for some of these antivirals use relative risk reductions from clinical trials without absolute risk reductions. The present paper reappraises recently published clinical trial data for the COVID-19 antivirals paxlovid, remdesivir, and molnupiravir, and reports absolute risk reductions, relative risk reductions, as well as number needed to treat to reduce severe illness, hospitalizations, and deaths. Relative risk reductions are 88.88% for paxlovid (95% CI: 72.13–95.56%), 86.48% for remdesivir (95% CI: 41.41–96.88%), and 30.41% for molnupiravir (95% CI: 0.81–51.18%), while absolute risk reductions are much lower at 5.73% for paxlovid (95% CI: 3.79–7.68%), 4.58% for remdesivir (95% CI: 1.79–7.38%), and 2.96% for molnupiravir (95% CI: 0.09–5.83%). Low absolute risk reductions and the high number of patients needed to treat to reduce severe COVID-19 infections, hospitalizations, and deaths challenge the clinical efficacy of antivirals approved or authorized by the U.S Food and Drug Administration. These findings apply to other populations with similar control event rates. Accurate information should be disseminated to the public when selecting treatments for COVID-19.
据报道,经美国食品和药物管理局批准或授权紧急使用的新冠肺炎抗病毒药物在预防重症、住院和死亡方面具有很高的疗效。然而,其中一些抗病毒药物的报告使用了临床试验中的相对风险降低,而没有绝对风险降低。本论文重新评估了最近发表的新冠肺炎抗病毒药物奈玛特韦片/利托那韦片组合包装、瑞德西韦和莫努匹拉韦的临床试验数据,并报告了绝对风险降低、相对风险降低以及减少重症、住院和死亡所需的治疗数量。奈玛特韦片/利托那韦片组合包装的相对风险降低率为88.88%(95%置信区间:72.13–95.56%),瑞德西韦的相对风险减少率为86.48%(95%置信度:41.41–96.88%),莫努匹拉韦的相对危险降低率为30.41%(95%可信区间:0.81–51.18%),而奈玛特韦片/利托那韦片组合包装的绝对危险降低率要低得多,分别为5.73%(95%置信指数:3.79–7.68%),莫努匹拉韦为2.96%(95%置信区间:0.09–5.83%)。绝对风险降低低,需要治疗的患者人数多,以减少严重的新冠肺炎感染、住院和死亡,这挑战了美国食品和药物管理局批准或授权的抗病毒药物的临床疗效。这些发现适用于具有相似对照事件发生率的其他人群。在选择新冠肺炎治疗方法时,应向公众传播准确的信息。
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引用次数: 2
The Era of Rhythm Control: A Review of the Epidemiology and Clinical Impact of Anti-Arrhythmic Medications in Atrial Fibrillation 心律控制的时代:房颤抗心律失常药物的流行病学和临床影响综述
Pub Date : 2023-03-07 DOI: 10.3390/pharma2010008
C. Dye, Jamario Skeete, Asad Khan, Michael Dunleavy, Michael Dietrich, A. Volgman, Parikshit S. Sharma, Henry Huang
Atrial fibrillation has been described as a global epidemic with a three-fold increase in prevalence in the last 50 years. As the prevalence of atrial fibrillation continues to grow, multiple landmark trials have been designed to determine the best method to treat atrial fibrillation. Initial trials have stated that rate control was not inferior to rhythm control, however, as the efficacy of rhythm control of atrial fibrillation has improved, a benefit in rhythm control has been shown. Because of this trend towards increased rhythm control, more patients have been placed on anti-arrhythmic medications. This paper will review the epidemiology and clinical impact of the utilization of anti-arrhythmic medications. As we enter the era of rhythm control, increased awareness is needed regarding the monitoring and potential adverse events that can occur with these medications. Providers must balance the increased emphasis on rhythm control with the overall clinical impact on their patients due to drug-to-drug interactions and adverse effects that can occur with different co-morbidities. If the clinical momentum towards rhythm control continues, real-world data analysis will be needed to evaluate the clinical impact of the use, risk, and benefits of anti-arrhythmic medications.
心房颤动被描述为一种全球流行病,在过去50年中发病率增加了三倍。随着心房颤动患病率的持续增长,已经设计了多项具有里程碑意义的试验来确定治疗心房颤动的最佳方法。初步试验表明,心率控制并不劣于节律控制,然而,随着心房颤动节律控制的疗效提高,节律控制也显示出了益处。由于这种增加心律控制的趋势,越来越多的患者接受了抗心律失常药物治疗。本文将综述抗心律失常药物应用的流行病学和临床影响。随着我们进入节奏控制时代,需要提高对这些药物可能发生的监测和潜在不良事件的认识。提供者必须平衡对心律控制的日益重视与药物间相互作用和不同合并症可能发生的不良反应对患者的总体临床影响。如果心律控制的临床势头持续下去,将需要进行真实世界的数据分析,以评估抗心律失常药物的使用、风险和益处的临床影响。
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引用次数: 0
Knowledge and Practices among Dental Practitioners Regarding the Use of Antimicrobials for Periodontal Diseases: An Online Survey in Saudi Arabia 牙科从业者对牙周病抗菌药物使用的知识和实践:沙特阿拉伯的在线调查
Pub Date : 2023-03-01 DOI: 10.3390/pharma2010007
M. S. Al-Ak’hali, E. Halboub, M. Kamil, Wafa H Alaajam, Abdulaziz Mahnashi, Jabbar A. Khubrani, Abdullah Mahnashi, Khalid Mahnashi, Nuha Farea
This study aimed to investigate the knowledge and practices among dental practitioners in Saudi Arabia regarding the use of antimicrobials for periodontal diseases. An online questionnaire was sent to senior dental students and dental practitioners including interns, general dental practitioners (GDP), and periodontists in Saudi Arabia. Two hundred and twenty-three dental practitioners responded and participated in the study. The potential associations between the use of antimicrobials and different variables were assessed by a chi-square test. The majority of the participants (84.3%) reported prescribing systemic antimicrobials for a periodontal abscess or acute necrotizing periodontal disease. Surprisingly, 31% of participants reported prescribing systemic antimicrobials for deep localized periodontal pockets or for acute gingivitis associated with herpes simplex in children. Noteworthy is that 66% of the participants thought that mechanical periodontal treatment alone, without adjunctive antimicrobial therapy, is adequate to resolve the clinical condition in most cases of periodontal diseases. Almost half of the participants recommended the use of local antimicrobials for a periodontal pocket (45.3%), a recurrent periodontal pocket (45.4%), and refractory periodontitis (43.7%). The barriers against the use of local antimicrobials were a lack of knowledge and a lack of continuous education after graduation, as reported by 64% of the participants. In conclusion, knowledge and practices regarding antimicrobial use for periodontal diseases were inadequate, especially among practitioners other than periodontists.
本研究旨在调查沙特阿拉伯牙科从业者对使用抗菌药物治疗牙周病的知识和实践。向沙特阿拉伯的高级牙科学生和牙科医生,包括实习生、全科牙科医生(GDP)和牙周病学家发送了一份在线问卷。223名牙科医生参与了这项研究。通过卡方检验评估了抗菌药物的使用与不同变量之间的潜在关联。大多数参与者(84.3%)报告称,他们为牙周脓肿或急性坏死性牙周病开具了系统抗菌药物处方。令人惊讶的是,31%的参与者报告称,他们为儿童深部局限性牙周袋或与单纯疱疹相关的急性牙龈炎开具了系统抗菌药物处方。值得注意的是,66%的参与者认为,在大多数牙周病病例中,仅进行机械牙周治疗,不进行辅助抗菌治疗,就足以解决临床状况。近一半的参与者建议使用局部抗菌药物治疗牙周袋(45.3%)、复发性牙周囊(45.4%)和难治性牙周炎(43.7%)。据64%的参与者报告,阻碍使用局部抗菌剂的障碍是缺乏知识和毕业后缺乏持续教育。总之,关于牙周病抗菌药物使用的知识和实践不足,尤其是在牙周病医生以外的从业者中。
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引用次数: 1
Pregnancy- and Birth-Related Experiences among Postpartum Women during the Third Wave of the COVID-19 Pandemic—A Multinational European Study 新冠肺炎第三波疫情期间产后妇女的妊娠和分娩相关经历——欧洲多国研究
Pub Date : 2023-02-03 DOI: 10.3390/pharma2010006
Robin A. Araya, Fatima Tauqeer, M. Ceulemans, Eva Gerbier, E. Maisonneuve, Anneke Passier, Alison Oliver, A. Panchaud, A. Lupattelli, H. Nordeng
The objective of this study was to describe pregnancy- and birth-related experiences of postpartum women during the third wave of the COVID-19 pandemic and their association with mental health outcomes. An online questionnaire was distributed in five European countries (Belgium, The Netherlands, Norway, Switzerland, UK) between June and August 2021. Participants were recruited though social media platforms including pregnancy- and motherhood-related websites, pregnancy fora, and apps. Postpartum women were asked eleven specific questions about pregnancy- and birth-related changes and the presence of support during delivery. The Edinburgh Depression Scale was used to assess depressive and anxiety symptoms. Covariates included sociodemographics, health and reproductive characteristics, and COVID-19 status. Associations were estimated with logistic regression. The study included 1730 postpartum women. Frequent changes included the exclusion of the partner from pregnancy care appointments (83.2%), changed prenatal care settings (64.4%), and cancellation of hospital information visits (42.7%). Few women, however, were without support apart from medical staff during delivery (1.4%). The number of pregnancy- and birth-related changes was associated with each woman’s mental health status, as well as the type of change. Experiencing changes related to delivery and cancellation or reduction of prenatal examination was associated with a doubling in the odds of symptoms of major depression and anxiety postpartum. These findings highlight the importance of ensuring adequate maternity care for women’s mental health postpartum, as well as during a pandemic.
本研究的目的是描述产后妇女在第三波新冠肺炎大流行期间的妊娠和分娩相关经历及其与心理健康结果的关系。2021年6月至8月,在五个欧洲国家(比利时、荷兰、挪威、瑞士、英国)分发了一份在线问卷。参与者是通过社交媒体平台招募的,包括与怀孕和母亲相关的网站、怀孕论坛和应用程序。产后妇女被问及11个关于妊娠和分娩相关变化以及分娩期间是否存在支持的具体问题。爱丁堡抑郁量表用于评估抑郁和焦虑症状。协变量包括社会人口统计学、健康和生殖特征以及新冠肺炎状况。通过逻辑回归估计关联性。这项研究包括1730名产后妇女。频繁的变化包括伴侣被排除在妊娠护理预约之外(83.2%)、产前护理环境的改变(64.4%)和医院信息访问的取消(42.7%)。然而,除了医护人员之外,很少有女性在分娩期间没有支持(1.4%)。与妊娠和分娩相关的变化数量与每个女性的心理健康状况有关,以及变化的类型。经历与分娩有关的变化以及取消或减少产前检查与产后出现严重抑郁和焦虑症状的几率增加一倍有关。这些发现强调了确保在产后以及疫情期间为女性心理健康提供充分的产妇护理的重要性。
{"title":"Pregnancy- and Birth-Related Experiences among Postpartum Women during the Third Wave of the COVID-19 Pandemic—A Multinational European Study","authors":"Robin A. Araya, Fatima Tauqeer, M. Ceulemans, Eva Gerbier, E. Maisonneuve, Anneke Passier, Alison Oliver, A. Panchaud, A. Lupattelli, H. Nordeng","doi":"10.3390/pharma2010006","DOIUrl":"https://doi.org/10.3390/pharma2010006","url":null,"abstract":"The objective of this study was to describe pregnancy- and birth-related experiences of postpartum women during the third wave of the COVID-19 pandemic and their association with mental health outcomes. An online questionnaire was distributed in five European countries (Belgium, The Netherlands, Norway, Switzerland, UK) between June and August 2021. Participants were recruited though social media platforms including pregnancy- and motherhood-related websites, pregnancy fora, and apps. Postpartum women were asked eleven specific questions about pregnancy- and birth-related changes and the presence of support during delivery. The Edinburgh Depression Scale was used to assess depressive and anxiety symptoms. Covariates included sociodemographics, health and reproductive characteristics, and COVID-19 status. Associations were estimated with logistic regression. The study included 1730 postpartum women. Frequent changes included the exclusion of the partner from pregnancy care appointments (83.2%), changed prenatal care settings (64.4%), and cancellation of hospital information visits (42.7%). Few women, however, were without support apart from medical staff during delivery (1.4%). The number of pregnancy- and birth-related changes was associated with each woman’s mental health status, as well as the type of change. Experiencing changes related to delivery and cancellation or reduction of prenatal examination was associated with a doubling in the odds of symptoms of major depression and anxiety postpartum. These findings highlight the importance of ensuring adequate maternity care for women’s mental health postpartum, as well as during a pandemic.","PeriodicalId":74431,"journal":{"name":"Pharmacoepidemiology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46330236","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Prescribing Patterns of Antibiotics According to the WHO AWaRe Classification during the COVID-19 Pandemic at a Teaching Hospital in Lusaka, Zambia: Implications for Strengthening of Antimicrobial Stewardship Programmes 赞比亚卢萨卡一所教学医院在COVID-19大流行期间根据世卫组织AWaRe分类的抗生素处方模式:对加强抗微生物药物管理规划的影响
Pub Date : 2023-02-02 DOI: 10.3390/pharma2010005
S. Mudenda, Eustus Nsofu, Patience Chisha, V. Daka, Billy Chabalenge, W. Mufwambi, Henson Kainga, M. Kanaan, R. Mfune, Florence Mwaba, M. Zulu, Rabecca Tembo, Wizaso Mwasinga, K. Chishimba, G. Mwikuma, Ngula Monde, M. Samutela, Harriet Chiyangi, Shafiq Mohamed, S. Matafwali
Irrational and inappropriate prescribing of antibiotics is a major problem that can lead to the development of antimicrobial resistance (AMR). In Zambia, there is insufficient information on the prescribing patterns of antibiotics according to the World Health Organization (WHO) AWaRe classification. Therefore, this study assessed the prescribing patterns of antibiotics using the AWaRe classification during the COVID-19 pandemic at the University Teaching Hospital in Lusaka, Zambia. A cross-sectional study was conducted using 384 patient medical files at the University Teaching Hospital in Lusaka, Zambia, from August 2022 to September 2022. All antibiotics were classified according to the WHO “AWaRe” tool and assessed for appropriateness using the 2020 Zambian Standard Treatment Guidelines. Of the 384 patient medical files reviewed, antibiotics were prescribed 443 times. The most prescribed antibiotics were ceftriaxone (26.6%), metronidazole (22.6%), amoxicillin (10.4%), amoxicillin/clavulanic acid (5.6%), and azithromycin (5%). The prescribing of 42.1% of “Watch” group antibiotics was greater than the recommended threshold by the WHO. Most antibiotics were prescribed for respiratory infections (26.3%) and gastrointestinal tract infections (16.4%). The most prescribed antibiotic was ceftriaxone, a Watch antibiotic. This is a worrisome observation and calls for strengthened antimicrobial stewardship and implementation of the AWaRe framework in prescribing antibiotics.
不合理和不适当的抗生素处方是一个可导致抗菌素耐药性(AMR)发展的主要问题。在赞比亚,根据世界卫生组织(世卫组织)《认识到》分类,关于抗生素处方模式的信息不足。因此,本研究评估了赞比亚卢萨卡大学教学医院在COVID-19大流行期间使用AWaRe分类的抗生素处方模式。在2022年8月至2022年9月期间,对赞比亚卢萨卡大学教学医院384名患者的医疗档案进行了横断面研究。根据世卫组织“AWaRe”工具对所有抗生素进行分类,并使用《2020年赞比亚标准治疗指南》对其适当性进行评估。在审查的384名患者的医疗档案中,处方抗生素的次数为443次。处方最多的抗生素是头孢曲松(26.6%)、甲硝唑(22.6%)、阿莫西林(10.4%)、阿莫西林/克拉维酸(5.6%)和阿奇霉素(5%)。42.1%的“观察”组抗生素处方量大于WHO推荐阈值。大多数抗生素用于呼吸道感染(26.3%)和胃肠道感染(16.4%)。处方最多的抗生素是头孢曲松(ceftriaxone)。这是一个令人担忧的观察结果,呼吁加强抗菌素管理,并在抗生素处方中实施《意识到》框架。
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引用次数: 10
Clinical Indicators of Cardiovascular Risk in Adult Patients Undergoing Chemotherapy: A Protocol for Scoping Review 接受化疗的成人患者心血管风险的临床指标:一个范围审查方案
Pub Date : 2023-02-01 DOI: 10.3390/pharma2010004
Karolini Zuqui Nunes, Jonathan Grassi, A. B. Lopes, Lucas Dalvi Armond Rezende, Julia Anhoque Cavalcanti, Karoline Neumann Gomes, Julia Antonietta Dantas da Silva, L. C. Lopes-Júnior
Heart disease and cancer are the main causes of morbidity and mortality worldwide. As the number of cancer survivors increases, cardiotoxicity associated with cancer treatment has become a major concern as it presents a substantial challenge in the follow-up of these patients. Here, we aimed to map the clinical indicators for cardiovascular risk in adult patients undergoing chemotherapy. A scoping review protocol adhering to the PRISMA-P statement and in accordance with the JBI guidelines will be conducted. Cochrane Library, MEDLINE/PubMed, Cochrane Library, EMBASE, Scopus, Web of Science, and PsycINFO as well as register sites such as ClinicalTrials.gov and WHO-ICTRP will be searched. Additional sources, including Google Scholar, The British Library, and medRXiv, will also be searched, with no date or idiom restrictions. A combination of subject headings, MeSH terms, Emtree terms, CINAHL Headings, and APA Thesaurus, using the Boolean terms AND/OR, will be performed. In addition, two independent researchers will conduct the overall steps of this review. The results will be presented via narrative summaries, considering the types of clinical indicators. To the best of our knowledge, this will be the first scoping review in the cardio-oncology field to map, via a rigorous review method, the clinical indicators for cardiovascular risk in adult cancer patients receiving chemotherapy.
心脏病和癌症是全世界发病率和死亡率的主要原因。随着癌症幸存者数量的增加,与癌症治疗相关的心脏毒性已成为一个主要问题,因为它在这些患者的随访中提出了实质性的挑战。在这里,我们的目的是绘制成人化疗患者心血管风险的临床指标。将根据PRISMA-P声明和JBI指南执行范围审查方案。检索Cochrane Library、MEDLINE/PubMed、Cochrane Library、EMBASE、Scopus、Web of Science、PsycINFO以及ClinicalTrials.gov和WHO-ICTRP等注册网站。其他来源,包括谷歌Scholar,大英图书馆和medRXiv,也将被搜索,没有日期或成语限制。将执行主题标题、MeSH术语、Emtree术语、CINAHL标题和APA Thesaurus的组合,使用布尔术语and /OR。此外,两名独立的研究人员将进行本综述的总体步骤。考虑到临床指标的类型,结果将通过叙述性摘要呈现。据我们所知,这将是心脏肿瘤学领域首次通过严格的审查方法,绘制成人癌症患者接受化疗的心血管风险临床指标的范围审查。
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引用次数: 0
Signal Detection Study Focusing on Differences in the Drug Delivery System of Oral 5-Aminosalicylate for Inflammatory Bowel Disease Using the Japanese Pharmacovigilance Database 基于日本药物警戒数据库的针对口服5-氨基水杨酸盐治疗炎症性肠病给药系统差异的信号检测研究
Pub Date : 2023-01-13 DOI: 10.3390/pharma2010003
Y. Noguchi, Shuji Yamashita, Hirofumi Tamaki, A. Osanai, Y. Ino, T. Tachi, K. Iguchi, H. Teramachi
Although 5-Aminosalicylate (5-ASA) has been shown to act on the local mucosa, when 5-ASA is orally administered, most of it is absorbed in the upper gastrointestinal tract and does not reach the large intestine, where lesions are present. Therefore, different drug delivery systems have been developed for each oral 5-ASA formulation. Currently, the oral 5-ASA formulation approved in Japan is salazosulfapyridine (SALAZOPYRIN®; Pfizer Japan Inc.: Tokyo, Japan), in which 5-ASA and sulfapyridine are azo-bonded. In addition, there are several 5-ASA release formulations, including ASACOL®; ZERIA Pharmaceutical Co., Ltd.: Tokyo, Japan (delayed release formulation dependent on pH), PENTASA®; KYORIN Pharmaceutical Co., Ltd.: Tokyo, Japan (delayed release formulation dependent on time), and LIALDA®; MOCHIDA Pharmaceutical Co., Ltd.: Tokyo, Japan (delayed release formulation dependent on pH and time). Adverse events may occur because of differences in the drug delivery systems of these products. In this study, we focused on the adverse events of different 5-ASA formulations and investigated differences in the detection of safety signals for each 5-ASA formulation using disproportionality analysis. There were 15 adverse events detected only with SALAZOPYRIN®. On the other hand, ASACOL®, PENTASA®, and LIALDA® have different drug delivery systems. Although the detected signal intensities varied, the detected adverse events were not significantly different. These findings provide important insights, which should be considered by physicians during treatment selection and drug manufacturers during drug development.
虽然5-氨基水杨酸(5-ASA)已被证明对局部粘膜起作用,但当5-ASA口服给药时,大部分被上胃肠道吸收,而不会到达存在病变的大肠。因此,针对每种口服5-ASA制剂开发了不同的给药系统。目前,在日本批准的口服5-ASA制剂是salazosulfapyridine (SALAZOPYRIN®;辉瑞日本公司:东京,日本),其中5-ASA和磺胺吡啶是偶氮键。此外,还有几种5-ASA释放制剂,包括ASACOL®;ZERIA Pharmaceutical Co., Ltd:东京,日本(取决于pH的缓释制剂),PENTASA®;KYORIN制药株式会社:日本东京(取决于时间的缓释制剂)和LIALDA®;MOCHIDA制药株式会社:日本东京(取决于pH和时间的缓释制剂)。由于这些产品的给药系统不同,可能会发生不良事件。在本研究中,我们重点研究了不同5-ASA配方的不良事件,并利用歧化分析研究了每种5-ASA配方在检测安全信号方面的差异。仅SALAZOPYRIN®组就检测到15个不良事件。另一方面,ASACOL®、PENTASA®和LIALDA®具有不同的给药系统。虽然检测到的信号强度不同,但检测到的不良事件没有显著差异。这些发现提供了重要的见解,医生在治疗选择和药物制造商在药物开发中应该考虑。
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引用次数: 0
Birth Outcomes of Anticancer Drug Prescriptions during Pregnancy: A Case Series from a Japanese Claims Database 妊娠期抗癌药物处方的出生结局:来自日本索赔数据库的一系列病例
Pub Date : 2023-01-06 DOI: 10.3390/pharma2010002
K. Tajima, Tomofumi Ishikawa, Masami Tsuchiya, M. Kikuchi, T. Obara, N. Mano
We aimed to evaluate the adverse birth outcomes of anticancer drug prescription during pregnancy using a Japanese claims database from 2005 to 2019. We applied validated claims-based algorithms to identify pregnant women with birth outcomes, and evaluated drug prescription during pregnancy. The causal relationship between anticancer drugs and adverse birth outcomes was evaluated using the Council for International Organizations of Medical Sciences Working Group VI criteria. Thirteen women with anticancer drugs prescription during pregnancy were identified (mean age: 34.6 years). Atrial/ventricular septal defect was observed in one infant after exposure to cyclophosphamide and doxorubicin for breast cancer in the second and third trimesters. One woman on several anticancer drugs (cyclophosphamide, cytarabine, daunorubicin, l-asparaginase, methotrexate, nelarabine, and vincristine) for acute lymphoblastic leukemia, one on imatinib for chronic myeloid leukemia, and one on cisplatin and fluorouracil for cervical cancer had miscarriages after exposure in the first trimester. A relationship between those anticancer drugs and miscarriage could not be ruled out, while no relationship was identified regarding the atrial/ventricular septal defect considering the period of exposure and organogenesis. Our results suggest increased risk of miscarriage with the use of several anticancer drugs such as methotrexate, imatinib, cisplatin, and fluorouracil in the first trimester.
我们旨在使用日本2005年至2019年的索赔数据库来评估妊娠期间抗癌药物处方的不良分娩结果。我们应用经过验证的基于索赔的算法来识别有分娩结果的孕妇,并评估妊娠期间的药物处方。使用国际医学科学组织理事会第六工作组标准评估抗癌药物与不良出生结局之间的因果关系。确定了13名在怀孕期间服用抗癌药物的妇女(平均年龄:34.6岁)。一名婴儿在服用环磷酰胺和多柔比星治疗癌症的第二个和第三个三个月观察到心房/室间隔缺损。一名服用多种抗癌药物(环磷酰胺、阿糖胞苷、柔红霉素、l-天冬酰胺酶、甲氨蝶呤、内阿拉伯碱和长春新碱)治疗急性淋巴细胞白血病的妇女,一名服用伊马替尼治疗慢性粒细胞白血病的妇女和一名服用顺铂和氟尿嘧啶治疗宫颈癌症的妇女在妊娠早期流产。不能排除这些抗癌药物与流产之间的关系,而考虑到暴露时间和器官发生,没有发现心房/室间隔缺损的关系。我们的研究结果表明,在妊娠早期使用几种抗癌药物,如甲氨蝶呤、伊马替尼、顺铂和氟尿嘧啶,流产风险会增加。
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引用次数: 0
Identifying Surgical and Trauma Patients in New Zealand for Opioid-Related Pharmacoepidemiological Research: A Descriptive Study 识别手术和创伤患者在新西兰阿片类药物相关的药物流行病学研究:一项描述性研究
Pub Date : 2022-12-27 DOI: 10.3390/pharma2010001
J. Gong, A. Chan, K. Beyene, A. Merry, A. Tomlin, P. Jones
Unique aspects of New Zealand’s (NZ) health system allow for a novel pharmacoepidemiologic approach to conducting population-based clinical research. A defined cohort of surgical and trauma patients would facilitate future studies into opioid utilisation, outcomes, and other questions related to surgery and trauma. We aimed to describe all patients admitted to a NZ hospital with trauma or to undergo surgery between 1 January 2007 to 31 December 2019. This was a retrospective population-based study involving all hospital centres in NZ. We excluded patients with hospitalisation episodes for surgery or trauma one year before the event. We identified 1.78 million surgical only patients, 633,386 trauma only, and 250,800 trauma with surgery patients. Trauma only patients had the highest prevalence of death within one year of event (17.8%), history of opioid dispensing (18.3%), mental health disorders (17.0%) and chronic pain (2.3%). Moreover, trauma patients also had the highest prevalence of those with higher comorbidity burden. We plan to use this dataset for future research into the prevalence and outcomes of persistent opioid use, and to make our dataset available to other researchers upon request. Our findings of significant differences between cohorts suggest studies should treat surgical and trauma patients separately.
新西兰卫生系统的独特方面为开展基于人群的临床研究提供了一种新的药物流行病学方法。一个明确的外科和创伤患者队列将有助于未来对阿片类药物的使用、结果以及与外科和创伤相关的其他问题进行研究。我们的目的是描述2007年1月1日至2019年12月31日期间因创伤入院或接受手术的所有患者。这是一项基于人群的回顾性研究,涉及新西兰所有医院中心。我们排除了在事件发生前一年因手术或创伤而住院的患者。我们确定了178万只接受手术的患者,633386只接受创伤,250800名接受手术的创伤患者。只有创伤的患者在事件发生后一年内死亡的发生率最高(17.8%),有阿片类药物分配史(18.3%),精神健康障碍(17.0%)和慢性疼痛(2.3%)。此外,创伤患者在合并症负担较高的患者中的发生率也最高。我们计划将该数据集用于未来对持续性阿片类药物使用的流行率和结果的研究,并根据要求向其他研究人员提供我们的数据集。我们发现队列之间存在显著差异,这表明研究应该分别治疗外科和创伤患者。
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Pharmacoepidemiology
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