[Study on mining of signals of adverse drug reactions of entecavir and tenofovir disoproxil based on the US FAERS database]

Zhonghua Gan Zang Bing Za Zhi. 2021 Sep 20;29(9):830-836. doi: 10.3760/cma.j.cn501113-20200117-00020.
[Article in Chinese]

Abstract

Objective: To mine the signals of adverse drug reaction (ADR) of entecavir and tenofovir by using the US FDA Adverse Event Reporting System (FAERS) database, so as to provide reference for the safe clinical use of these two drugs. Methods: Reporting odds ratio (ROR) and proportion of report ratio (PRR) method were used to conduct data mining on the 26 quarterly reports of the US Food and Drug Administration Adverse Event Reporting System (FAERS) database between the fourth quarter of 2012 to the first quarter of 2019. The ADR descriptive terminology in the report were standardized by using the World Health Organization Adverse Reaction Terminology (System-Organ Class). ROR and PRR methods common signals were screened. Results: 104 and 187 signals of ADR of entecavir and tenofovir dipivoxil were obtained by ROR and PRR methods. The main screened system-organ classes affected by signals of ADR of entecavir were systemic damage, hepatobiliary system damage, and urinary system damage. The main screened system-organ classes affected by signals of ADR of tenofovir were urinary system damage, skeletal and musculoskeletal system damage, and metabolic and nutritional disorders. Conclusion: The mining signals of adverse drug reaction of entecavir and tenofovir dipivoxil indicate that these two drugs can cause female reproductive system damage, fetal abnormalities, neonatal and infant abnormalities, and male reproductive system damage. However, in addition to the above-mentioned ADR, the ADR instruction manual excludes entecavir and tenofovir dipivoxil primarily for respiratory and visual system damage, and the tenofovir disoproxil primarily for skin and appendage damage, and hearing and vestibular function damage. Therefore, in clinical medication management, it is suggested to pay close attention to the choice of drugs for special population infected with HBV, monitor possible ADR during medication course, and provide pharmacological monitoring to achieve personalized medication.

目的: 利用美国食品药品监督管理局(FDA)不良事件报告系统(FAERS)数据库挖掘恩替卡韦和替诺福韦的不良反应(ADR)信号,为两药的临床安全使用提供参考。 方法: 采用报告比值比法(ROR)和比例报告比值法(PRR),对美国FDA不良事件报告系统2012年第4季度至2019年第1季度共26个季度的报告进行数据挖掘,采用世界卫生组织药品不良反应术语集累及的系统、器官对报告中的ADR描述用语进行标准化,筛选出ROR法和PRR法共有信号。 结果: 通过使用ROR法和PRR法共得到恩替卡韦ADR信号104个,替诺福韦酯ADR信号187个,筛选出的恩替卡韦ADR信号主要累及的器官、系统为:全身性损害,肝胆系统损害,泌尿系统损害;筛选出的替诺福韦ADR信号主要累及的器官、系统为:泌尿系统损害,骨骼肌肉系统损害,代谢和营养障碍。 结论: 经挖掘所得的恩替卡韦和替诺福韦酯不良反应信号均提示两药可导致女性生殖系统损害、胎儿异常、新生儿和婴儿异常及男性生殖系统损伤,恩替卡韦与替诺福韦酯除上述ADR外,恩替卡韦特有且未收录在说明书中的ADR信号主要涉及呼吸系统损害及视觉损害,替诺福韦酯特有且未收录在说明书中的ADR信号主要涉及皮肤及其附件损害、听觉和前庭功能损害。提示临床用药时应密切关注感染HBV的特殊人群的药物选择,监测用药过程中可能出现的ADR,并提供药学监护,做到个体化用药。.

Keywords: Entecavir; Measures of disproportionality; Tenofovir; The ADR signals.

MeSH terms

  • Adverse Drug Reaction Reporting Systems*
  • Drug-Related Side Effects and Adverse Reactions* / epidemiology
  • Female
  • Guanine / analogs & derivatives
  • Humans
  • Infant, Newborn
  • Male
  • Tenofovir / adverse effects
  • United States / epidemiology
  • United States Food and Drug Administration

Substances

  • entecavir
  • Guanine
  • Tenofovir