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Li J, Li M, Li L, Ma L, Cao A, Wen A, Chen W, Li L, Liang Y, Deng J. Real-world safety of ulinastatin: a post-marketing surveillance of 11,252 patients in China. BMC Pharmacol Toxicol 2022; 23:51. [PMID: 35842685 PMCID: PMC9288682 DOI: 10.1186/s40360-022-00585-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2022] [Accepted: 06/28/2022] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND The safety assessment of ulinastatin can guide clinical practice. The present study aimed to investigate the real-world safety of ulinastatin in China. METHODS This multicenter study retrospectively analyzed the post-marketing surveillance data of consecutive patients treated with ulinastatin between August 2014 and June 2017 in the general wards and the intensive care units (ICU) of nine hospitals in China. Adverse drug reactions/adverse drug events (ADRs/ADEs) were collected and evaluated in a post-marketing database. RESULTS A total of 11,252 consecutive patients were included in the study: 7009 ICU patients and 4243 general ward patients. Eleven patients with ADRs/ADEs were observed, including nine ICU patients and two general ward patients. The clinical manifestations were liver dysfunction (n = 5 ICU cases, n = 1 general case), thrombocytopenia (n = 2 ICU cases, n = 1 general case), leukopenia (n = 1 ICU case), and rash (n = 1 ICU case). During the study period, the drug ADR/ADE rate of ulinastatin injection was 0.98‰ (11/11,252 × 1000‰). Among the 11,252 valid patients, only 327 received ulinastatin in accordance with the drug specifications. After excluding unreasonable drug use, the calculated ADR rate was 3.06‰ (1/327 × 1000‰) (95% confidence interval: 0.0‰-17.1‰). In ICU and general ward patients, the use of other drugs combined with ulinastatin was associated with the occurrence of ADRs/ADEs (100% with ADRs/ADEs vs. 0% in controls, P < 0.001). CONCLUSIONS The incidence of ADRs/ADEs of ulinastatin is < 5‰. The ADRs/ADEs involved limited organs, mainly the skin, gastrointestinal tract, and blood. In most cases, the ADRs/ADEs gradually alleviated or recovered after drug withdrawal. The inappropriate/off-label use of ulinastatin should be the focus of surveillance.
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Affiliation(s)
- Jin Li
- Pharmacy Department, Guangzhou United Family Hospital, Guangzhou, 510335, Guangdong, China
- Guangdong Province Pharmacological Society, No. 753 East Dongfeng Road, Guangzhou, 510080, Guangdong, China
| | - Meijun Li
- Guangdong Province Pharmacological Society, No. 753 East Dongfeng Road, Guangzhou, 510080, Guangdong, China
| | - Liren Li
- Department of Pharmacy, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, Guangdong, China
| | - Lin Ma
- Managed Service Organization, Guangdong Hospital of Traditional Chinese Medicine, Guangzhou, 510120, Guangdong, China
| | - Ailin Cao
- Department of Medicines and Devices, The First Affiliated Hospital of Naval Military Medical University (Shanghai Changhai Hospital), Shanghai, 200433, China
| | - Aiping Wen
- Department of Pharmacy, Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, China
| | - Wenge Chen
- Department of Industrial Engineering, College of Mechanical and Electrical Engineering, Guangdong University of Technology, Guangzhou, 518049, Guangdong, China
| | - Lingling Li
- Guangdong Province Pharmacological Society, No. 753 East Dongfeng Road, Guangzhou, 510080, Guangdong, China
| | - Yan Liang
- Guangdong Province Pharmacological Society, No. 753 East Dongfeng Road, Guangzhou, 510080, Guangdong, China
| | - Jianxiong Deng
- Guangdong Province Pharmacological Society, No. 753 East Dongfeng Road, Guangzhou, 510080, Guangdong, China.
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He Y, Gao XM, Li L, Liu XG, Liu W, Hong XJ, Huang BH, Yang HL, Xue MH, Wu XJ, Liu JF. Safety of the Xuesaitong injection in China: results from a large-scale multicentre post-marketing surveillance study in a real-world setting. Curr Med Res Opin 2020; 36:1947-1953. [PMID: 33016133 DOI: 10.1080/03007995.2020.1832056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVE The safety profile of traditional Chinese medicine injections has emerged as the greatest challenge to their clinical application. The authors aimed to perform a post-marketing surveillance study in a real-world setting to evaluate the safety of the Xuesaitong (XST) injection in China. METHODS This multi-centre, post-marketing, observational study enrolled patients who received XST injections in 42 centres in China between March 2015 and November 2017. Adverse drug reactions (ADRs) and adverse drug events (ADEs) were collected and evaluated in a post-marketing database. Logistic regression analysis was performed to analyse the risk factors for ADRs. RESULTS A total of 30,008 consecutive patients with a mean age of 62.29 ± 14.58 years were included in this post-marketing study. The incidences of ADEs and ADRs were 0.5% and 0.33%, respectively. The most common clinical manifestations were damage to skin and appendages (47.66%). There were four new kinds of ADEs found in the present monitoring study. The majority of ADRs were type B (62.62%) and occurred within 24 h after XST injection treatment. No severe ADRs were reported in this analysis. Multivariate logistic regression analysis showed that the hospital level (OR = 0.607; 95% CI = 0.407-0.906; p = .0144), hypertension (OR = 1.979; 95% CI, 1.323-2.959; p = .0009) and solvent type (OR = 2.951; 95% CI, 1.608-5.417; p = .0005) were risk factors for ADR occurrence. CONCLUSION XST injection is well tolerated and has a favourable safety profile for patients in a real-world setting. This post-marketing study provided further evidence of the safety of XST injections for clinical applications.
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Affiliation(s)
- Yan He
- ADR Monitoring Center, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Xue-Min Gao
- Professional Committee of Pharmaceutcal Research and Clinical Evaluation, China Association of Traditional Chinese Medicine, Beijing, China
| | - Lei Li
- Professional Committee of Pharmaceutcal Research and Clinical Evaluation, China Association of Traditional Chinese Medicine, Beijing, China
| | - Xiao-Guang Liu
- Clinical Evaluation Center, Beijing COMPETE Pharmaceutical Research and Clinical Evaluation Center, Beijing, China
| | - Wei Liu
- Clinical Pharmacy Office, The Third Affiliated Hospital of Xinxiang Medical University, Xinxiang, China
| | - Xue-Jun Hong
- Department of Pharmacy, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, China
| | - Bang-Hua Huang
- Department of Pharmacy, The First People's Hospital of Yunnan Province/The Affiliated Hospital of Kunming University of Science and Technology, Kunming, China
| | - Hong-Lian Yang
- Clinical Medical Research Center, The Affiliated Hospital of Shanxi University of Traditional Chinese Medicine, Xianyang, China
| | - Ming-Hui Xue
- Clinical Research Center, Kunming Pharmaceutical, Inc, Kunming, China
| | - Xiao-Jun Wu
- Marketing Department, Kunming Pharmaceutical, Inc, Kunming, China
| | - Jun-Feng Liu
- R&D Institute, Kunming Pharmaceutical, Inc, Kunming, China
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