口服肠道清洁剂和缺血性结肠炎风险:现实世界的不成比例分析
Min Luo1, Wenyu Li1, Xuehong Wang1
1Gastroenterology Department of the Second Xiangya Hospital, The Central South University, Changsha, Hunan, China.
PloS one
|September 29, 2025
概括
缺血性结肠炎 (IC) 的风险与肠道准备剂有关. 比萨科迪尔显示出最强的信号,而聚乙烯糖醇 (PEG) 也引发了担忧,特别是在患有并发症的老年患者中.
科学领域:
- 胃肠病学 胃肠病学
- 药物监督 药物监督 药物监督
- 临床药理学 临床药理学
背景情况:
- 缺血性结肠炎 (IC) 是肠道准备的一个未被认可的并发症.
- 之前的研究报告了零星病例,但药物特定的关联和真正的频率仍然不清楚.
研究的目的:
- 评估口服肠道清洁剂和缺血性结肠炎 (IC) 之间的关联.
- 确定与IC相关的特定病原体,并评估严重结果的风险因素.
主要方法:
- 对FDA不良事件报告系统 (FAERS) 数据 (2004-2024) 的不成比例分析.
- 与比萨科迪尔,聚乙烯糖醇 (PEG) 和口服硫酸盐溶液 (OSS) 相关的已确定IC病例.
- 使用多变量逻辑回归来探索与IC和严重临床结果相关的因素.
主要成果:
- 在43,958份肠道清洁剂不良事件报告中,发现了75例IC病例.
- 比萨科迪尔对IC (ROR=237.25) 显示出最强的不成比例信号,其次是OSS (ROR=3.64) 和PEG (ROR=2.18).
- 高龄 (≥70岁) 和心血管并发症与严重的结局有关,包括PEG相关的IC死亡.
结论:
- 本次药监分析强调了与比萨科迪尔相关的显著IC风险,并提出了关于PEG安全性的担忧.
- 研究结果表明需要个性化肠道准备策略,特别是对于患有并发病的老年患者.
- 这项研究强调了监测与肠道制备剂相关的不良事件的重要性.
相关概念视频
01:27Inflammatory Bowel Disease I: Ulcerative Colitis
903
Introduction
Inflammatory bowel disease, or IBD, encompasses a group of disorders characterized by chronic inflammation or ulceration of the gastrointestinal tract.
Risk Factors
The exact cause of IBD remains unclear, although it is believed to be due to a mix of genetic, environmental, microbial, and immune factors. Genetic factors are significant in determining susceptibility to IBD, with family history being a critical risk factor. Individuals with a first-degree relative who has IBD are at...
Inflammatory bowel disease, or IBD, encompasses a group of disorders characterized by chronic inflammation or ulceration of the gastrointestinal tract.
Risk Factors
The exact cause of IBD remains unclear, although it is believed to be due to a mix of genetic, environmental, microbial, and immune factors. Genetic factors are significant in determining susceptibility to IBD, with family history being a critical risk factor. Individuals with a first-degree relative who has IBD are at...
903
01:21Drugs for Treatment of Constipation-Predominant IBS
724
Pharmacological therapies for IBS-C are designed to alleviate abdominal discomfort and enhance bowel function. In patients with IBS-C, fiber supplements may help soften stools and decrease straining, but may also lead to increased gas production and bloating. Osmotic laxatives like milk of magnesia are frequently used to soften stools and increase stool frequency in IBS-C patients. In addition, two drugs approved for use in severe IBS-C adult cases are linaclotide (Linzess) and lubiprostone...
724
01:17Drugs for Treatment of Diarrhea-Predominant IBS
634
Diarrhea-predominant irritable bowel syndrome (IBS-D) is a subtype of IBS characterized primarily by frequent, loose, or watery stools, abdominal pain, and abdominal discomfort. Therapeutic approaches to managing IBS-D include dietary changes, stress management techniques, and pharmaceutical interventions.
Two specific drugs used in the treatment are alosetron (Lotronex) and eluxadoline (Viberzi). Alosetron, a 5-HT3 antagonist, works by slowing the movement of stools in the gut, reducing bowel...
Two specific drugs used in the treatment are alosetron (Lotronex) and eluxadoline (Viberzi). Alosetron, a 5-HT3 antagonist, works by slowing the movement of stools in the gut, reducing bowel...
634
01:30Inflammatory Bowel Disease III: Diagnostic Studies and Management I-Nutritional Therapy
643
Various diagnostic tests are employed in the diagnostic process for Inflammatory Bowel Disease (IBD), particularly to differentiate between Crohn's disease and ulcerative colitis.
Diagnostic studies
A colonoscopy is the definitive screening test, distinguishing ulcerative colitis from other colon diseases with similar symptoms. During a colonoscopy test, inflamed mucosa with exudate ulcerations can be observed, and biopsies are taken to determine the histologic characteristics of the...
Diagnostic studies
A colonoscopy is the definitive screening test, distinguishing ulcerative colitis from other colon diseases with similar symptoms. During a colonoscopy test, inflamed mucosa with exudate ulcerations can be observed, and biopsies are taken to determine the histologic characteristics of the...
643
01:29Drugs for Treatment of Ulcerative Colitis in IBD
460
Ulcerative colitis is a chronic inflammatory condition primarily affecting the colon and rectum. The primary drugs used in the treatment of ulcerative colitis are aminosalicylates. They exhibit anti-inflammatory and immunosuppressive properties. They modulate inflammatory mediators and inhibit the activity of nuclear factor κB (NF-κB). Aminosalicylates also reduce inflammation by inhibiting prostaglandin and leukotriene production and decreasing neutrophil chemotaxis and superoxide...
460
01:20Drugs Affecting GI Tract Motility: Other Laxatives
1.0K
Laxatives are primarily used to alleviate constipation, a common gastrointestinal disorder characterized by infrequent bowel movements and difficulty passing stools. They work by various mechanisms to increase the volume or frequency of bowel movements. The primary modes of action of laxatives include increasing stool bulk, softening the stool, stimulating intestinal motility, and osmotically drawing water into the intestines.
Osmotic or saline laxatives, like magnesium hydroxide or milk of...
Osmotic or saline laxatives, like magnesium hydroxide or milk of...
1.0K