对止痛药诱导的内分泌腺损伤及其潜在机制的研究
Qian Liu1,2,3,4,5,6,7, Shiwei Sun1,3,4,5,6,7, Xinyue Chu1,3,4,5,6,7
1Key Laboratory of Endocrine Glucose & Lipids Metabolism and Brain Aging, Ministry of Education, Jinan, Shandong, China.
Expert opinion on drug safety
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概括
某些止痛药,特别是阿片类药物,与内分泌功能障碍有关,特别是在女性和老年人中. 由于已识别的风险和潜在的途径中断,建议进行个性化监测.
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:
- 止痛药通常用于缓解疼痛,但它们可能导致内分泌功能障碍的可能性尚不清楚.
- 本研究调查了与止痛药使用相关的内分泌相关不良事件 (AE).
- 它旨在确定高风险患者群体,并探索潜在的生物机制.
研究的目的:
- 进行与止痛药相关的内分泌AE的药监测分析.
- 确定具有内分泌风险的特定止痛药和最脆弱的人群.
- 探索涉及这些不良事件的潜在分子途径.
主要方法:
- 从2004年第一季度到2023年第三季度使用了FDA不良事件报告系统 (FAERS) 数据库.
- 使用OpenVigil 2.1进行不成比例分析,以评估止痛药和内分泌AEs之间的关联.
- 进行了年龄和性别分层和分子通路丰富分析.
主要成果:
- 阿片类药物表现出最强的内分泌关联,可代因与甲状腺和下丘脑垂体损伤有关,甲与丸损伤有关.
- 弗鲁比 (NSAID) 与胰腺损伤有关; gabapentin 和 pregabalin 没有显著的内分泌风险.
- 在女性和60岁及以上的个体中观察到较高的风险,具体例子如与可代因相关的副甲状腺损伤在女性中更为普遍.
结论:
- 不是所有的特定止痛药都与显著的内分泌风险有关.
- 女性和老年人代表这些不良事件的高风险人群.
- 建议对患者进行个性化监测,尽管剂量反应数据仍然有限.
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