在美国行政索赔数据库中监测因偏头痛而接触过加坎珠单抗的孕妇。

IF 2.4 4区 医学 Q3 PHARMACOLOGY & PHARMACY Pharmacoepidemiology and Drug Safety Pub Date : 2024-10-01 DOI:10.1002/pds.70015
Sarah R Hoffman, Francis Mawanda, Christopher L Crowe, Dustin D Ruff, Stephan Lanes, Krista Schroeder
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引用次数: 0

摘要

目的:加坎珠单抗是一种降钙素基因相关肽单克隆抗体,适用于成人偏头痛的预防。由于galcanezumab的半衰期较长,而且育龄妇女中偏头痛的发病率较高,因此在怀孕期间可能会接触到galcanezumab。然而,galcanezumab在妊娠期的实际使用情况和安全性尚未得到充分描述。为了填补这一空白,加康珠单抗正在进行两项妊娠安全性研究,其中一项是保险理赔数据库研究:这项数据库研究利用医疗保健综合研究数据库(HIRD)中的商业索赔,积极识别和跟踪暴露于加坎珠单抗的孕妇。计划从 2018 年 9 月至 2026 年 6 月累积患者,并计划于 2027 年 12 月提交最终研究报告。这项研究需要430例加坎珠单抗暴露的孕妇和相关婴儿,以达到对主要先天性畸形进行比较分析的能力:最近对患者累积情况的监测(包括 2018 年 9 月 28 日至 2023 年 1 月 31 日的数据)发现,在 HIRD 中,偏头痛女性中有 207 例妊娠暴露于加坎珠单抗,其中 110 例为活产,73 例与婴儿有关。这意味着每年约有17例与婴儿有关的妊娠,大大低于在目前监管部门承诺的研究时限内达到目标规模所需的每年55例妊娠:结论:累积足够数量的加坎儿珠单抗暴露妊娠是进行妊娠研究比较分析的一大障碍,但这一障碍并不少见。可能存在一些潜在的解决方案,可以及时向患者和医疗服务提供者传播重要的安全性信息。
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Monitoring Pregnancies Exposed to Galcanezumab for Migraine in a United States Administrative Claims Database.

Purpose: Galcanezumab is a calcitonin gene-related peptide monoclonal antibody indicated for migraine prevention in adults. Due to the long half-life of galcanezumab and the prevalence of migraine in women of childbearing age, galcanezumab exposure may occur during pregnancy. However, real-world use and safety of galcanezumab during pregnancy has not been fully described. To help fill this gap, galcanezumab has two ongoing pregnancy safety studies, one of which is an insurance claims database study.

Methods: This database study is actively identifying and following pregnancies exposed to galcanezumab using commercial claims from the Healthcare Integrated Research Database (HIRD). Patient accrual is planned from September 2018 to June 2026, with a final study report planned for December 2027. This study requires 430 galcanezumab-exposed pregnancies with linked infants to reach power for comparative analysis of major congenital malformations.

Results: Recent monitoring of patient accrual, including data from 28 September 2018 to 31 January 2023, identified 207 galcanezumab-exposed pregnancies in women with migraine in the HIRD, of which 110 were live births and 73 of which were linked to an infant. This represents an annual accrual rate of approximately 17 pregnancies linked to infants, which is substantially lower than the 55 required annually to reach target size within current regulatory-committed study timelines.

Conclusions: The accrual of a sufficient number of galcanezumab-exposed pregnancies represents a substantial, but not uncommon, barrier to conducting comparative analyses in pregnancy studies. Potential solutions that would allow for timely dissemination of important safety information to patients and providers may be available.

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来源期刊
CiteScore
4.80
自引率
7.70%
发文量
173
审稿时长
3 months
期刊介绍: The aim of Pharmacoepidemiology and Drug Safety is to provide an international forum for the communication and evaluation of data, methods and opinion in the discipline of pharmacoepidemiology. The Journal publishes peer-reviewed reports of original research, invited reviews and a variety of guest editorials and commentaries embracing scientific, medical, statistical, legal and economic aspects of pharmacoepidemiology and post-marketing surveillance of drug safety. Appropriate material in these categories may also be considered for publication as a Brief Report. Particular areas of interest include: design, analysis, results, and interpretation of studies looking at the benefit or safety of specific pharmaceuticals, biologics, or medical devices, including studies in pharmacovigilance, postmarketing surveillance, pharmacoeconomics, patient safety, molecular pharmacoepidemiology, or any other study within the broad field of pharmacoepidemiology; comparative effectiveness research relating to pharmaceuticals, biologics, and medical devices. Comparative effectiveness research is the generation and synthesis of evidence that compares the benefits and harms of alternative methods to prevent, diagnose, treat, and monitor a clinical condition, as these methods are truly used in the real world; methodologic contributions of relevance to pharmacoepidemiology, whether original contributions, reviews of existing methods, or tutorials for how to apply the methods of pharmacoepidemiology; assessments of harm versus benefit in drug therapy; patterns of drug utilization; relationships between pharmacoepidemiology and the formulation and interpretation of regulatory guidelines; evaluations of risk management plans and programmes relating to pharmaceuticals, biologics and medical devices.
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