Study on analgesic-induced endocrine gland damage and its potential mechanisms

Area of Science:

• Pharmacovigilance
• Endocrinology
• Drug Safety

Background:

• Analgesics are commonly used for pain relief, but their potential to cause endocrine dysfunction is not well understood.
• This study investigates endocrine-related adverse events (AEs) associated with analgesic use.
• It aims to identify high-risk patient groups and explore the underlying biological mechanisms.

Purpose of the Study:

• To conduct a pharmacovigilance analysis of analgesic-associated endocrine AEs.
• To identify specific analgesics posing endocrine risks and the populations most vulnerable.
• To explore potential molecular pathways involved in these adverse events.

Main Methods:

• Utilized the FDA Adverse Event Reporting System (FAERS) database from Q1 2004 to Q3 2023.
• Employed OpenVigil 2.1 for disproportionality analysis to assess associations between analgesics and endocrine AEs.
• Performed age and gender stratification and molecular pathway enrichment analysis.

Main Results:

• Opioids showed the strongest endocrine associations, with codeine linked to parathyroid and hypothalamic-pituitary injury, and methadone to testicular injury.
• Flurbiprofen (NSAID) was associated with pancreatic injury; gabapentin and pregabalin showed no significant endocrine risks.
• Elevated risks were observed in females and individuals aged 60 years and older, with specific examples like codeine-associated parathyroid injury being more prevalent in females.

Conclusions:

• Specific analgesics, not all, are associated with significant endocrine risks.
• Females and older adults represent high-risk populations for these adverse events.
• Personalized patient monitoring is recommended, although dose-response data remains limited.