双基化酶-4抑制剂的综合安全概况:基于FAERS数据库的营销后研究,使用信号检测算法
Beema T Yoosuf1, Muhammed Favas Kt1, Pinaki Dutta2
1Department of Pharmacy Practice, National Institute of Pharmaceutical Education and Research, Mohali, Punjab, India.
Expert opinion on drug safety
|April 16, 2024
概括
用于治疗2型糖尿病的二乙酶-4 (DPP-4) 抑制剂存在安全问题. 对不良事件报告的分析揭示了包括心力衰竭,胰腺炎和损伤在内的潜在风险,需要谨慎处方.
科学领域:
- 药物监督 药物监督 药物监督
- 内分泌学 在内分泌学.
- 药品安全 药品安全
背景情况:
- 双基化酶-4 (DPP-4) 抑制剂被广泛用于2型糖尿病管理.
- 对于DPP-4抑制剂的整体安全性概况存在担忧.
- 这项研究调查了与DPP-4抑制剂相关的潜在风险.
研究的目的:
- 评估DPP-4抑制剂的潜在安全风险.
- 分析来自FDA不良事件报告系统 (FAERS) 数据库的不良事件数据.
主要方法:
- 追溯分析到2023年3月的FAERS数据库数据.
- 使用信号检测算法 (SDA) 的不成比例分析.
- 基于频率的数据挖掘:相对报告比率 (RRR),报告几率比率 (ROR),比例报告比率 (PRR) 与95%置信区间 (CI).
主要成果:
- 对DPP-4抑制剂的14573份不良事件报告被确定.
- 对心力衰竭,胰腺炎,皮虫,低血糖,急性损伤和乳酸性酸性检测到积极的安全信号.
- 发现的特定关联:萨克萨格利普丁 (心力衰竭),西塔格利普丁 (胰腺炎),阿洛格利普丁 (胰腺癌).
结论:
- 显著的不成比例信号表明DPP-4抑制剂的潜在风险.
- 在处方这些药物时,临床医生必须考虑患者的并发症和并发药物.
相关概念视频
Dipeptidyl Peptidase 4 Inhibitors
182
Dipeptidyl peptidase 4 (DPP-4) is a serine protease widely distributed in the body. It's involved in the inactivation of GLP-1 and GIP hormones, which are crucial for insulin regulation. DPP-4 inhibitors, such as sitagliptin (Januvia), saxagliptin (Onglyza), linagliptin (Tradjenta), alogliptin (Nesina), and vildagliptin (Galvus), help increase the proportion of active GLP-1, enhancing insulin secretion. These inhibitors work by competitively binding to DPP-4. This binding causes a...
182
Pharmacovigilance
830
Post-marketing surveillance is a critical component of pharmaceutical regulation, often uncovering unanticipated adverse drug reactions (ADRs) once a drug is widely used over an extended period.
This process, termed pharmacovigilance, aims to detect, evaluate, and minimize harmful effects related to medication use. The data collection for pharmacovigilance depends on spontaneous reporting systems, where healthcare professionals or patients voluntarily report suspected ADRs.
In some cases, there...
This process, termed pharmacovigilance, aims to detect, evaluate, and minimize harmful effects related to medication use. The data collection for pharmacovigilance depends on spontaneous reporting systems, where healthcare professionals or patients voluntarily report suspected ADRs.
In some cases, there...
830
Glucagon-like Receptor Agonists
319
Incretins include glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP), which stimulate insulin secretion post-meals. In type 2 diabetes, GIP's efficacy is reduced, making GLP-1 a viable drug target. GIP originates from preproGIP.
GLP-1, when administered in high doses intravenously, triggers insulin secretion, inhibits glucagon release, slows gastric emptying, reduces food intake, and restores normal insulin secretion. However, its rapid inactivation by...
GLP-1, when administered in high doses intravenously, triggers insulin secretion, inhibits glucagon release, slows gastric emptying, reduces food intake, and restores normal insulin secretion. However, its rapid inactivation by...
319
Oral Hypoglycemic Agents: Biguanides and Glitazones
195
Biguanides, particularly metformin (Glucophage), are insulin sensitizers that enhance glucose uptake, thereby reducing insulin resistance. Unlike sulfonylureas, metformin doesn't prompt insulin secretion, which helps to curb hypoglycemia risk. Metformin is beneficial in treating conditions like polycystic ovary syndrome due to its insulin-resistance reduction capability. The drug's primary action involves curtailing hepatic gluconeogenesis, a significant contributor to high blood...
195
Insulin: Dosing Regimen and Adverse Effects
169
Insulin-replacement therapy usually includes both long-acting insulin (basal) and short-acting insulin (to cater to postprandial needs). In a diverse group of type 1 diabetes patients, the average daily insulin dose is typically 0.5-0.7 units/kg body weight. However, obese patients and pubertal adolescents may need more due to insulin resistance.
The basal dose constitutes about 40%-50% of the total daily dose, with the rest as premeal insulin. The mealtime insulin dose should mirror...
The basal dose constitutes about 40%-50% of the total daily dose, with the rest as premeal insulin. The mealtime insulin dose should mirror...
169
Oral Hypoglycemic Agents: Glinides
154
Repaglinide (Prandin) and Nateglinide (Starlix), known as glinides, are oral insulin secretagogues that stimulate insulin release from pancreatic β cells by closing the ATP-sensitive potassium channels (KATP channel). Repaglinide controls insulin release from pancreatic β cells by managing potassium efflux. It shares two binding sites with sulfonylureas and also has a unique site, indicating overlapping mechanisms of action. With a rapid onset and a 4-7 hour duration, it effectively...
154


