scholarly journals Comparison of Rhabdomyolysis Associated With Sacubitril/valsartan-related Drug-drug Interactions by Individual Statins in an Adverse Event Reporting System

Author(s):  
Tomiko Sunaga ◽  
Ryo Yonezawa

Abstract BackgroundSacubitril/valsartan was approved in Japan recently. Sacubitril is an inhibitor of organic anion-transporting polypeptide (OATP) 1B1 and 1B3. In Japan, sacubitril/valsartan product labeling indicates that it should be cautiously co-administered with atorvastatin due to drug-drug interactions (DDIs). However, all statins are the substrates of OATP1B1 and/or 1B3. Therefore, we should be cautious about DDIs between sacubitril/valsartan and all other statins.ObjectiveTo evaluate the association between rhabdomyolysis and concomitant association of sacubitril/valsartan with atorvastatin and all other statins.MethodsCase reports from the U.S. Food and Drug Administration’s Adverse Event Reporting System (FAERS) from 2015 to Q4/2020 were used. All FAERS reports on sacubitril/valsartan were captured through a structured analysis. We compared the proportion of cases reporting the adverse events associated with rhabdomyolysis and the concomitant use of sacubitril/valsartan and atorvastatin to those with sacubitril/valsartan and all other statins.ResultsAmong 10,940 case reports on sacubitril/valsartan, compared with all other drugs, statin users were associated with increased rhabdomyolysis (reporting odds ratio =4.54[2.62-7.87]). However, compared with all other statins, atorvastatin was not associated with increased rhabdomyolysis. ConclusionsWe suggest that the co-administration of sacubitril/valsartan with atorvastatin as well as other statins should be carefully managed as it may induce rhabdomyolysis.

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Xiaojiang Tian ◽  
Yao Yao ◽  
Guanglin He ◽  
Yuntao Jia ◽  
Kejing Wang ◽  
...  

AbstractThis current investigation was aimed to generate signals for adverse events (AEs) of darunavir-containing agents by data mining using the US Food and Drug Administration Adverse Event Reporting System (FAERS). All AE reports for darunavir, darunavir/ritonavir, or darunavir/cobicistat between July 2006 and December 2019 were identified. The reporting Odds Ratio (ROR), proportional reporting ratio (PRR), and Bayesian confidence propagation neural network (BCPNN) were used to detect the risk signals. A suspicious signal was generated only if the results of the three algorithms were all positive. A total of 10,756 reports were identified commonly observed in hepatobiliary, endocrine, cardiovascular, musculoskeletal, gastrointestinal, metabolic, and nutrition system. 40 suspicious signals were generated, and therein 20 signals were not included in the label. Severe high signals (i.e. progressive extraocular muscle paralysis, acute pancreatitis, exfoliative dermatitis, acquired lipodystrophy and mitochondrial toxicity) were identified. In pregnant women, umbilical cord abnormality, fetal growth restriction, low birth weight, stillbirth, premature rupture of membranes, premature birth and spontaneous abortion showed positive signals. Darunavir and its boosted agents induced AEs in various organs/tissues, and were shown to be possibly associated with multiple adverse pregnant conditions. This study highlighted some novel and severe AEs of darunavir which need to be monitored prospectively.


2017 ◽  
Vol 62 (1) ◽  
Author(s):  
Erica Yookyung Lee ◽  
Aisling R. Caffrey

ABSTRACT Several studies have suggested the risk of thrombocytopenia with tedizolid, a second-in-class oxazolidinone antibiotic (approved June 2014), is less than that observed with linezolid (first-in-class oxazolidinone). Using data from the Food and Drug Administration adverse event reporting system (July 2014 through December 2016), we observed significantly increased risks of thrombocytopenia of similar magnitudes with both antibiotics: linezolid reporting odds ratio [ROR], 37.9 (95% confidence interval [CI], 20.78 to 69.17); tedizolid ROR, 34.0 (95% CI, 4.67 to 247.30).


2020 ◽  
pp. 135245852094998
Author(s):  
Natalia Gonzalez Caldito ◽  
Afsaneh Shirani ◽  
Amber Salter ◽  
Olaf Stuve

Background: Rituximab and ocrelizumab are anti-CD20 monoclonal antibodies that have shown a marked reduction in multiple sclerosis (MS) inflammatory activity. However, their real-world safety profile has not been adequately compared. Objective: To investigate the adverse event (AE) profile of rituximab and ocrelizumab reported to the Food and Drug Administration Adverse Event Reporting System (FAERS) database. Methods: The FAERS database was filtered by indication (MS) and drug (rituximab or ocrelizumab). Disproportionality analyses including but not limited to reporting odds ratio (ROR) were conducted to identify drug–AE associations. A signal was detected if the lower limit of the 95% confidence interval of ROR (ROR025) exceeded 1. Results: There were 623 and 7948 reports for rituximab and ocrelizumab, respectively. The most frequent AEs with rituximab and ocrelizumab were infusion-related reaction (4.82%) and urinary tract infection (10.52%), respectively. The strongest drug–AE association for rituximab and ocrelizumab were ear pruritus (ROR025: 47.53) and oral herpes (ROR025: 38.99), respectively. Ocrelizumab was associated with an almost two times higher frequency of infections than rituximab (21.93% vs 11.05%, respectively). Conclusion: This study revealed differences in reporting AEs between rituximab and ocrelizumab. Infections were reported more frequently with ocrelizumab. Although speculative, a potentially different or more extensive B-cell depletion by ocrelizumab might explain these findings. Additional pharmacovigilance studies need to be performed to better characterize differences in the AE profile in B-cell-depleting therapies.


2021 ◽  
Author(s):  
Bin Wu ◽  
Qiaozhi Hu ◽  
Fangyuan Tian ◽  
Fengbo Wu ◽  
Yuwen Li ◽  
...  

Abstract Proton pump inhibitors (PPIs) were widely used around the world. Studies suggested conflicting results between PPIs treatment and the risk of dementia. This study examined the association between six PPIs and dementia risk by mining the US FDA Adverse Event Reporting System (FAERS) database from 2004 to 2019. We employed reporting odds ratio (ROR) and proportional reporting ratio (PRR) to detect the signals of dementia relevant to PPIs. We also analyzed characteristics of PPI reports, compared dementia events between short- and long- duration PPIs treatment. Finally, we identified 2104 dementia cases with PPIs treatment. We did not detect significant signals between PPIs and dementia, ROR = 0.99, 95%CI 0.94–1.03, PRR = 0.99, 95%CI 0.95–1.03, even in gastroesophageal reflux disease cases ROR = 0.65, 95%CI 0.58–0.73, PRR = 0.67, 95%CI 0.60–0.74. No significant differences of dementia events were detected between short- and long- duration groups, the OR (95%CI) of the 6 months, 1 year, 3 years and 5 years comparison were 0.85 (0.68–1.06), 0.92 (0.71–1.18), 0.81 (0.57–1.15) and 0.79 (0.52–1.22), respectively. Based on the current FAERS data mining, we discovered no association between PPIs use and the risk of dementia.


2019 ◽  
Vol 64 (3) ◽  
Author(s):  
Tristan T. Timbrook ◽  
Lydia McKay ◽  
Jesse D. Sutton ◽  
Emily S. Spivak

ABSTRACT Antistaphylococcal penicillins such as nafcillin and oxacillin are among the first choices of treatment for severe invasive methicillin-susceptible Staphylococcus aureus (MSSA) infections, although there has been limited safety evaluations between individual agents. Using the FDA Adverse Event Reports System (FAERS), oxacillin was observed to have a lower proportion of reports of acute renal failure (reporting odds ratio [ROR], 5.3 [95% confidence interval {CI}, 3.1 to 9.3] versus 21.3 [95% CI, 15.8 to 28.6], respectively) and hypokalemia (ROR, 0.7 [95% CI, 0.1 to 4.8] versus 11.4 [95% CI, 7.1 to 18.3], respectively) than nafcillin.


Blood ◽  
2005 ◽  
Vol 106 (11) ◽  
pp. 2251-2251
Author(s):  
Dennis W. Raisch ◽  
Charles L. Bennett ◽  
Jonathan Nebeker ◽  
Rita Jakiche ◽  
Ken Carson

Abstract Introduction: In 2002 and 2003, Ortho Biotech Products, L.P. issued “Dear Health Professional” letters describing two distinct episodes with distribution of counterfeit epoetin (ProcritÒ). The first episode in 2002 occurred when counterfeit labels marked as “40,000 Unit” vials were switched onto 2,000 Unit Procrit vials (5% potency). An estimated 97,000 vials of this product were not recovered, as many as 25,000 patients may have been exposed. A second episode occurred in 2003 when bacteria-contaminated tap water was added to vials that were labeled as containing “40,000 Units” of Procrit®. The “Dear Doctor” letters describe the subtle labeling and other product packaging features that distinguish the products from authentic. In addition, specific lot numbers are identified. We reviewed all MedWatch reports from the United States’ Food and Drug Administration (FDA) for confirmed or possible cases of counterfeit epoetin. Methods: For the years 1998 to 2004, the FDA’s adverse event reporting system (AERS) was searched, using key words: “suspected product tampering,” “decreased drug effect” and related terms, and all epoetin product names. We summarized the demographic variables for the cases and identified the lot numbers reported within the cases. Results: Seven cases of “medication tampering” were identified in the FDA’s Adverse Event Reporting System (AERS) database - all 7 included Procrit® lot numbers identified in the “Dear Health Professional” Warning Letters from OrthoBiotech. The cases had been reported to the FDA by pharmacists (n=5), a consumer (n=1), and a nurse (n=1). In six of these case reports, among cancer patients, death also listed on the report, although counterfeit product was not listed as the proximate cause of death. There were no case reports identified by the diagnostic term of “pharmaceutical product counterfeit”, which was added to the FDA’s AERS in 2004. We identified an additional 643 cases of MedWatch cases that were coded with the diagnostic labels of “drug ineffective”, “therapeutic response decreased”, “drug effect decreased”, “condition aggravated”, and similar terms. The mean age equal to 59.7± 17.7 years, range 5–95 years. There were 269 females (42%) and 358 males (55%), gender not reported for 3%. All epoietin products were included. Finally, one case was found with a reported lot number corresponding to one listed in the warning letters. Death occurred in this 89 year-old patient. Conclusion: Health professionals should be alert for potential counterfeit drugs whenever drug effects are less than expected and the pharmaceutical is costly. Whenever suspected, the occurrences should be reported to the FDA and the manufacturer as possible “pharmaceutical product counterfeit.” The use of radio frequency identification (RFID), planned to be implemented in 2007 may help prevent the domestic distribution of counterfeit drugs, but increases in direct importation of drugs from international sources will potentially increase the likelihood of distribution of counterfeit drugs domestically.


2021 ◽  
Vol 9 ◽  
Author(s):  
Xiaoyan Tang ◽  
Xiaolin Xu ◽  
Ji Li ◽  
Bin Zhao

Purpose: Biologic agent-induced cardiotoxicity is markedly concerning. Rheumatoid arthritis (RA) treated with biologic agents is known to have the potential for cardiotoxicity; however, existing clinical evidence is not adequate to explain real-world patterns of cardiotoxicity. In this study, we quantify the risk of cardiotoxicity in patients with rheumatoid arthritis treated with biological agents.Methods: Cardiotoxicity reports induced by four types of biologic agents, abatacept, adalimumab, tocilizumab, and etanercept were used to mine data from the FDA's adverse event reporting system (FAERS) database from January 1, 2004 through September 30, 2020. Reports of cardiotoxic events were analyzed using a reporting odds ratio (ROR) algorithm, the proportional reporting ratio (PRR), the Bayesian confidence propagation neural network (BCPNN), the multi-item gamma Poisson shrinker (MGPS), and logistic regression methods. We use the preferred term of the Medical Dictionary of Regulatory Activities to identify such events.Results: A total of 3,969 reports of cardiotoxic events were identified involving biologic agents used for RA as the suspect drugs in this study, 317 reports of abatacept, 2,137 reports of adalimumab, 273 reports of tocilizumab, and 1,242 reports of etanercept. Adalimumab was the most reported, followed by etanercept. The proportion of death and disability outcomes reported for each targeted treatment represents approximately 20–25% of the total reported severe adverse events. In addition, relatively low cardiotoxicity reporting rates were found with abatacept.Conclusion: Analysis of FAERS data offers a more precise profile on the characteristics and occurrences of cardiotoxic events. The findings are a clinical reminder to physicians that an increased vigilance concerning the cardiotoxic effects of biological agents needs to be implemented. Also, more comparative studies are required in the future to explain the mechanisms that cause these cardiac phenomena.


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