多巴胺激动剂的比较安全信号:来自FDA不良事件报告系统 (FAERS) 数据的精神和心血管风险
Li Mu1,2, Jing Xu1,3, Xiaomei Ye1,4
1Department of Pharmacy, Peking University Third Hospital, No.49 North Garden Road, Haidian District, Beijing, 100191, China.
BMC pharmacology & toxicology
|March 11, 2025
概括
对帕金森病的多巴胺受体激动剂 (DA) 有不同的安全性. 非ergot DA与精神问题有关,而ergot-DA带来心脏风险,指导个性化的帕金森病治疗.
科学领域:
- 药监和药物安全 药监和药物安全
- 神经学和运动障碍 神经学和运动障碍
- 临床药理学 临床药理学
背景情况:
- 多巴胺受体激活剂 (DAs) 是帕金森病的主要治疗方法.
- 有限的比较数据存在于不同DA的安全概况.
- 了解不良事件 (AE) 概况对于个性化帕金森病治疗至关重要.
研究的目的:
- 为了比较六种常用的多巴胺受体激动剂的安全性概况.
- 识别与特定的DA相关的明显不良事件模式.
- 为帕金森病患者的个性化治疗策略提供信息.
主要方法:
- 从FDA不良事件报告系统 (FAERS) 数据库 (Q2 2007-Q4 2023) 中提取了DA的AE报告.
- 分析了大约1970万个与DA相关的AE报告.
- 使用四种不成比例分析方法 (ROR,PRR,BCPNN,MGPS) 来评估AE风险.
主要成果:
- 非ergot的DA (pramipexole,ropinirole,rotigotine,apomorphine) 显示精神疾病的风险更高,包括幻觉.
- 普拉米佩克索尔对冲动控制障碍 (ICD) 的信号最强,而罗皮尼罗尔的幻觉风险比普拉米佩克索尔高.
- 埃尔戈特-DAs (勃罗莫克里普丁,卡贝戈林) 显示心脏疾病的信号增加;卡贝戈林也显示了对记忆力症状的信号.
- 罗提古丁和阿波莫尔芬与更多的注射部位相关的副作用有关.
结论:
- 在六个研究的药物中,确定了不同的安全概况.
- 非ergot DA主要与精神病不良事件有关.
- 埃尔戈特-DA携带更高的心脏并发症风险,需要仔细选择和监测患者.
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