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Byskov PK, Baden CS, Andersen JT, Jimenez-Solem E, Olsen RH, Gade C, Lausten-Thomsen U. Adverse drug reactions in neonates: a brief analysis of the FDA adverse event reporting system. Front Pharmacol 2024; 15:1395982. [PMID: 38903999 PMCID: PMC11188682 DOI: 10.3389/fphar.2024.1395982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2024] [Accepted: 04/30/2024] [Indexed: 06/22/2024] Open
Abstract
Introduction Drug trials in neonates are scarce, and the neonates may consequently be at risk of adverse drug reactions (ADRs). Spontaneous ADR reporting is an important tool for expanding the knowledge on drug safety in neonates. This study explores the quality of current neonatal ADR reports and the ADR reports of the most common drugs used in neonatal departments. Methods An observational cross-sectional study focused on neonates was conducted using data on spontaneous reports extracted from the U.S. Food and Drug Administration Adverse Events Reporting System (FAERS) from the third quarter of 2014 up to December 2022. Only the primary suspect drugs given to neonates or subjects aged <30 days were included in the analysis. Results Spontaneous reports from 13 million patients of all ages, totaling 50 million ADRs, were evaluated. Information regarding the age was missing in 40% of the reports, and data on 43,737 neonates with 948 different suspected drugs were identified and included in the analysis. We report the frequency of spontaneous ADR reports in the FAERS database for the ten most frequently administered drugs in neonatal intensive care units in the USA. Conclusion Overall, neonatal ADRs are still underreported. The FAERS database in its current form discriminates insufficiently between prenatal and postnatal drug exposures. Hence, improved neonatal pharmacovigilance systems are urgently needed.
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Affiliation(s)
- Pernille Kähler Byskov
- Department of Clinical Pharmacology, Copenhagen University Hospital–Bispebjerg and Frederiksberg, Copenhagen, Denmark
| | - Christoffer Storm Baden
- Department of Clinical Pharmacology, Copenhagen University Hospital–Bispebjerg and Frederiksberg, Copenhagen, Denmark
| | - Jon Trærup Andersen
- Department of Clinical Pharmacology, Copenhagen University Hospital–Bispebjerg and Frederiksberg, Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Espen Jimenez-Solem
- Department of Clinical Pharmacology, Copenhagen University Hospital–Bispebjerg and Frederiksberg, Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Ramus Huan Olsen
- Department of Clinical Pharmacology, Copenhagen University Hospital–Bispebjerg and Frederiksberg, Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Christina Gade
- Department of Clinical Pharmacology, Copenhagen University Hospital–Bispebjerg and Frederiksberg, Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Ulrik Lausten-Thomsen
- Department of Neonatology, Copenhagen University Hospital–Rigshospitalet, Copenhagen, Denmark
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2
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Golder S, O'Connor K, Wang Y, Gonzalez Hernandez G. The Role of Social Media for Identifying Adverse Drug Events Data in Pharmacovigilance: Protocol for a Scoping Review. JMIR Res Protoc 2023; 12:e47068. [PMID: 37531158 PMCID: PMC10433020 DOI: 10.2196/47068] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 05/05/2023] [Accepted: 05/06/2023] [Indexed: 08/03/2023] Open
Abstract
BACKGROUND Adverse drug events (ADEs) are a considerable public health burden resulting in disability, hospitalization, and death. Even those ADEs deemed nonserious can severely impact a patient's quality of life and adherence to intervention. Monitoring medication safety, however, is challenging. Social media may be a useful adjunct for obtaining real-world data on ADEs. While many studies have been undertaken to detect adverse events on social media, a consensus has not yet been reached as to the value of social media in pharmacovigilance or its role in pharmacovigilance in relation to more traditional data sources. OBJECTIVE The aim of the study is to evaluate and characterize the use of social media in ADE detection and pharmacovigilance as compared to other data sources. METHODS A scoping review will be undertaken. We will search 11 bibliographical databases as well as Google Scholar, hand-searching, and forward and backward citation searching. Records will be screened in Covidence by 2 independent reviewers at both title and abstract stage as well as full text. Studies will be included if they used any type of social media (such as Twitter or patient forums) to detect any type of adverse event associated with any type of medication and then compared the results from social media to any other data source (such as spontaneous reporting systems or clinical literature). Data will be extracted using a data extraction sheet piloted by the authors. Important data on the types of methods used (such as machine learning), any limitations of the methods used, types of adverse events and drugs searched for and included, availability of data and code, details of the comparison data source, and the results and conclusions will be extracted. RESULTS We will present descriptive summary statistics as well as identify any patterns in the types and timing of ADEs detected, including but not limited to the similarities and differences in what is reported, gaps in the evidence, and the methods used to extract ADEs from social media data. We will also summarize how the data from social media compares to conventional data sources. The literature will be organized by the data source for comparison. Where possible, we will analyze the impact of the types of adverse events, the social media platform used, and the methods used. CONCLUSIONS This scoping review will provide a valuable summary of a large body of research and important information for pharmacovigilance as well as suggest future directions of further research in this area. Through the comparisons with other data sources, we will be able to conclude the added value of social media in monitoring adverse events of medications, in terms of type of adverse events and timing. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) PRR1-10.2196/47068.
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Affiliation(s)
- Su Golder
- Department of Health Sciences, University of York, York, United Kingdom
| | - Karen O'Connor
- Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Yunwen Wang
- Department of Computational Biomedicine, Cedars-Sinai Medical Center, West Hollywood, CA, United States
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3
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Han N, Oh JM, Kim IW. Adverse Events Related to Off-Label Drugs Using Spontaneous Adverse Event Reporting Systems. Ther Clin Risk Manag 2021; 17:877-887. [PMID: 34456568 PMCID: PMC8387311 DOI: 10.2147/tcrm.s321789] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Accepted: 08/10/2021] [Indexed: 12/16/2022] Open
Abstract
Purpose The purpose of this study was to investigate the adverse events (AEs) related to the use of off-label drugs. Materials and Methods A cross-sectional study was carried out using available data pertaining to off-label drug were sourced from U.S. FDA spontaneous adverse drug reaction reporting database (FAERS) and Korea Adverse Event Reporting System database (KIDS-KD) for the years 2014 to 2018. The number and frequencies of AE cases were calculated. Disproportionality was analyzed using the proportional reporting ratio (PRR), the reporting odds ratio (ROR), the information component (IC), and the empirical Bayes geometric mean (EBGM) methods. Results The reported AEs associated with off-label drug use were more common among older patients compared with younger patients. Gastric nonspecific symptoms and therapeutic procedure (4.16–4.57%) and haemorrage term (4.16–5.29%) were the most common AE symptoms and antithrombotic agents and immunosuppressants were the drugs most commonly reported to cause AEs in FAERS. Secondary term events (43.45–48.62%) including inappropriate schedule of drug administration and medication error were the most common AEs, and immunosuppressants and antipsychotics were the most common AE-related drugs from KIDS-KD. The numbers of reported AEs in new drug categories such as other antineoplastic agents trended to increase from 2014 to 2018 in both datasets. Conclusion The numbers of reported AEs with off-label drug increased annually. AEs associated with off-label drugs may have a significant impact on older patients. Healthcare experts should be concerned about prescriptions of off-label drugs, especially anticoagulants and newly developed drugs such as immunosuppressants and antineoplastic agents.
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Affiliation(s)
- Nayoung Han
- Research Institute of Pharmaceutical Sciences, Seoul National University, Seoul, Republic of Korea.,College of Pharmacy, Jeju National University, Jejusi, Jeju Special Self-Governing Province, Republic of Korea
| | - Jung Mi Oh
- Research Institute of Pharmaceutical Sciences, Seoul National University, Seoul, Republic of Korea.,College of Pharmacy, Seoul National University, Seoul, Republic of Korea
| | - In-Wha Kim
- Research Institute of Pharmaceutical Sciences, Seoul National University, Seoul, Republic of Korea
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4
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Hawcutt DB, Warner N, Kenyon E, Murray C, Taylor J, Moss J, McWilliam S, Weston W, Murdock N. Implementing a specialist paediatric clinical pharmacology service in a UK children's hospital. Br J Clin Pharmacol 2021; 88:206-213. [PMID: 34133055 PMCID: PMC9291288 DOI: 10.1111/bcp.14944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 05/14/2021] [Accepted: 05/28/2021] [Indexed: 11/29/2022] Open
Abstract
Aims Royal College of Paediatrics and Child Health subspecialist training in Paediatric Clinical Pharmacology and Therapeutics has been delivered in the UK for 20 years, but no specialist clinical services have been set up previously. Methods Prospective audit and service evaluation of paediatric clinical pharmacology service pilot phase and dedicated service at a UK children's hospital. Results Pilot scheme (May–October 2019), then weekly service (established June 2020). Service covers the High Dependency Unit, and inpatients with polypharmacy. The pilot demonstrated high levels of acceptance, with 89% of suggested medication changes agreed by lead clinical team, and success, with 97.5% of suggested changes continued until discharge/pilot completion. Economic analysis estimated direct annualised cost savings on medications of up to £10 000. After 20 ward rounds of the established service, 270 potential medication changes were identified, 213 were carried out (78.9%). The most common were deprescribing (n = 143), prescribing (n = 47) and dose adjustment (n = 8). Seventy‐five different medications were deprescribed, most commonly chloral hydrate (n = 12), Lactulose, ibuprofen, Bio‐Kult and sodium alginate (all n = 4). The percentage of inpatients prescribed ≥10 medications decreased from 38.5 to 32.1%, while the subset prescribed ≥20 medications decreased from 11.0 to 5.67%. The mean number of medicines prescribed decreased from 9.0 to 8.0, while the median was unchanged at 7. Annual Yellow Card reports of suspected adverse drug reactions more than doubled (n = 66). Conclusion A UK model for subspecialist paediatric clinical pharmacology service delivery has demonstrated a positive clinical impact and could be replicated at other UK secondary/tertiary children's hospitals.
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Affiliation(s)
- Daniel B Hawcutt
- Women's and Children's Health, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, UK.,NIHR Alder Hey Clinical Research Facility, Alder Hey Children's Hospital, Liverpool, UK.,Alder Hey Children's Hospital, Liverpool, UK
| | | | | | | | | | - James Moss
- NIHR Alder Hey Clinical Research Facility, Alder Hey Children's Hospital, Liverpool, UK
| | - Stephen McWilliam
- Women's and Children's Health, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, UK.,NIHR Alder Hey Clinical Research Facility, Alder Hey Children's Hospital, Liverpool, UK
| | - Will Weston
- Alder Hey Children's Hospital, Liverpool, UK
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5
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Efficacy, Retention and Tolerability of Everolimus in Patients with Tuberous Sclerosis Complex: A Survey-Based Study on Patients' Perspectives. CNS Drugs 2021; 35:1107-1122. [PMID: 34275102 PMCID: PMC8478774 DOI: 10.1007/s40263-021-00839-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/21/2021] [Indexed: 12/18/2022]
Abstract
BACKGROUND The approval of everolimus (EVE) for the treatment of angiomyolipoma (2013), subependymal giant cell astrocytoma (2013) and drug-refractory epilepsy (2017) in patients with tuberous sclerosis complex (TSC) represents the first disease-modifying treatment option available for this rare and complex genetic disorder. OBJECTIVE The objective of this study was to analyse the use, efficacy, tolerability and treatment retention of EVE in patients with TSC in Germany from the patient's perspective. METHODS A structured cross-age survey was conducted at 26 specialised TSC centres in Germany and by the German TSC patient advocacy group between February and July 2019, enrolling children, adolescents and adult patients with TSC. RESULTS Of 365 participants, 36.7% (n = 134) reported the current or past intake of EVE, including 31.5% (n = 115) who were taking EVE at study entry. The mean EVE dosage was 6.1 ± 2.9 mg/m2 (median: 5.6 mg/m2, range 2.0-15.1 mg/m2) in children and adolescents and 4 ± 2.1 mg/m2 (median: 3.7 mg/m2, range 0.8-10.1 mg/m2) in adult patients. An early diagnosis of TSC, the presence of angiomyolipoma, drug-refractory epilepsy, neuropsychiatric manifestations, subependymal giant cell astrocytoma, cardiac rhabdomyoma and overall multi-organ involvement were associated with the use of EVE as a disease-modifying treatment. The reported efficacy was 64.0% for angiomyolipoma (75% in adult patients), 66.2% for drug-refractory epilepsy, and 54.4% for subependymal giant cell astrocytoma. The overall retention rate for EVE was 85.8%. The retention rates after 12 months of EVE therapy were higher among adults (93.7%) than among children and adolescents (88.7%; 90.5% vs 77.4% after 24 months; 87.3% vs 77.4% after 36 months). Tolerability was acceptable, with 70.9% of patients overall reporting adverse events, including stomatitis (47.0%), acne-like rash (7.7%), increased susceptibility to common infections and lymphoedema (each 6.0%), which were the most frequently reported symptoms. With a total score of 41.7 compared with 36.8 among patients not taking EVE, patients currently being treated with EVE showed an increased Liverpool Adverse Event Profile. Noticeable deviations in the sub-items 'tiredness', 'skin problems' and 'mouth/gum problems', which are likely related to EVE-typical adverse effects, were more frequently reported among patients taking EVE. CONCLUSIONS From the patients' perspective, EVE is an effective and relatively well-tolerated disease-modifying treatment option for children, adolescents and adults with TSC, associated with a high long-term retention rate that can be individually considered for each patient. Everolimus therapy should ideally be supervised by a centre experienced in the use of mechanistic target of rapamycin inhibitors, and adverse effects should be monitored on a regular basis.
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Roberts EK, Hawcutt DB, Turner MA. Prospective identification and causality evaluation of suspected adverse drug reactions in neonates. Br J Clin Pharmacol 2020; 87:1541-1546. [PMID: 32696451 PMCID: PMC9328662 DOI: 10.1111/bcp.14485] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2019] [Revised: 03/27/2020] [Accepted: 04/29/2020] [Indexed: 12/31/2022] Open
Abstract
Neonates experience adverse drug reactions (ADRs), but under-reporting of suspected ADRs to national spontaneous reporting schemes in this population is particularly high. A prospective observational study collected suspected neonatal ADRs at a tertiary neonatal unit. Cases were analysed for causality by six assessors using three existing methods. Sixty-three suspected ADR cases were identified in 35/193 neonates (18.1%). The proportion of suspected ADRs where the drug was prescribed "off-label" was 30/68 (44.1%). When 34 cases were assessed for causality using three methods, global kappa scores of less than 0.3 for each tool suggested only "fair" inter-rater reliability. Neonatal ADRs can be captured and occur from a variety of drugs affecting many organ systems. The current tools for assessing causality need to be adapted before they can reliably assess neonatal ADRs.
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Affiliation(s)
- Eve K Roberts
- Department of Women's and Children's Health, Institute of Lifecourse and Medical Science, University of Liverpool, Liverpool Health Partners, Liverpool, UK
| | - Daniel B Hawcutt
- Department of Women's and Children's Health, Institute of Lifecourse and Medical Science, University of Liverpool, Liverpool Health Partners, Liverpool, UK.,NIHR Alder Hey Clinical Research Facility, Alder Hey Children's Hospital, Liverpool, UK
| | - Mark A Turner
- Department of Women's and Children's Health, Institute of Lifecourse and Medical Science, University of Liverpool, Liverpool Health Partners, Liverpool, UK.,Liverpool Women's NHS Foundation Trust, Liverpool, UK
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7
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Prendergast AJ, Goga AE, Waitt C, Gessain A, Taylor GP, Rollins N, Abrams EJ, Lyall EH, de Perre PV. Transmission of CMV, HTLV-1, and HIV through breastmilk. THE LANCET CHILD & ADOLESCENT HEALTH 2020; 3:264-273. [PMID: 30878119 DOI: 10.1016/s2352-4642(19)30024-0] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/07/2018] [Revised: 01/16/2019] [Accepted: 01/17/2019] [Indexed: 12/14/2022]
Abstract
Breastfeeding is a crucial child survival intervention. However, the potential for transmission of viral infections from mother to child presents the dilemma of how best to interpret the benefits and risks of breastfeeding in different settings. In this Review, we compare the transmission dynamics, risk factors, and outcomes of infection with three chronic viruses transmitted through breastmilk: cytomegalovirus, human T-cell lymphotropic virus type 1, and HIV. We provide an overview of intervention approaches and discuss scientific, policy, and programming gaps in the understanding of these major global infections.
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Affiliation(s)
- Andrew J Prendergast
- Blizard Institute, Queen Mary University of London, London, UK; Zvitambo Institute for Maternal and Child Health Research, Harare, Zimbabwe.
| | - Ameena E Goga
- South African Medical Research Council, Cape Town, South Africa; Department of Paediatrics, University of Pretoria, Hatfield, South Africa
| | - Catriona Waitt
- Department of Molecular and Clinical Pharmacology, University of Liverpool, Liverpool, UK; Infectious Diseases Institute, Makerere University College of Health Sciences, Kampala, Uganda
| | | | | | - Nigel Rollins
- Department of Maternal, Newborn, Child and Adolescent Health, World Health Organization, Geneva, Switzerland
| | - Elaine J Abrams
- ICAP at Columbia, Mailman School of Public Health, and Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - E Hermione Lyall
- Department of Paediatrics, Imperial College Healthcare NHS Trust, London, UK
| | - Philippe Van de Perre
- Pathogenesis and Control of Chronic Infection, INSERM, University Montpellier, Etablissement Français du Sang, CHU de Montpellier, Montpellier, France
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8
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Noda A, Sakai T, Tsuchiya M, Oyanagi G, Obara T, Mano N. Characteristics of Adverse Events Following Immunization Reporting in Children: The Japanese Adverse Drug Event Report Database. Vaccines (Basel) 2020; 8:vaccines8030357. [PMID: 32635349 PMCID: PMC7564739 DOI: 10.3390/vaccines8030357] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Revised: 06/30/2020] [Accepted: 06/30/2020] [Indexed: 01/30/2023] Open
Abstract
The present study aimed to describe the trends and characteristics of adverse events following immunization (AEFI) reporting for children in the Japanese Adverse Drug Event Report database (JADER). We used 6280 AEFI reports for children aged <19 years among 504,407 ADR reports included in the JADER from 2004 to 2017. The number of AEFI reports gradually increased among children aged <10 years and was the highest in 2011 among children aged 10–19 years. The number of suspected vaccines per AEFI report increased after 2011 among children aged <10 years. The percentage of “death” and “did not recover” as AEFI outcomes reported were 4.3% and 3.7% among children aged <10 years and 0.2% and 21.1% among children aged 10–19 years, respectively. The most frequently reported vaccine–reaction pair was Haemophilus influenzae type b conjugate vaccine and pyrexia among children aged <10 years and recombinant adsorbed bivalent human papillomavirus-like particle vaccine and a loss of consciousness among children aged 10–19 years. It is necessary to consider the Weber effects to understand the trend and characteristics of AEFI reporting because pharmacovigilance activity regarding vaccination is not sufficient in Japan.
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Affiliation(s)
- Aoi Noda
- Division of Preventive Medicine and Epidemiology, Tohoku University Tohoku Medical Megabank Organization, Sendai, Miyagi 980-8573, Japan;
- Division of Molecular Epidemiology, Environment and Genome Research Center, Graduate School of Medicine, Tohoku University, Sendai, Miyagi 980-8573, Japan
- Department of Pharmaceutical Sciences, Tohoku University Hospital, Sendai, Miyagi 980-8574, Japan; (G.O.); (N.M.)
| | - Takamasa Sakai
- Drug Informatics, Faculty of Pharmacy, Meijo University, Nagoya, Aichi 468-8503, Japan;
| | - Masami Tsuchiya
- Laboratory of Clinical Pharmacy, Tohoku University Graduate School of Pharmaceutical Sciences, Sendai, Miyagi 980-8574, Japan;
- Department of Pharmacy, Miyagi Cancer Center, Natori 981-1293, Miyagi, Japan
| | - Gen Oyanagi
- Department of Pharmaceutical Sciences, Tohoku University Hospital, Sendai, Miyagi 980-8574, Japan; (G.O.); (N.M.)
| | - Taku Obara
- Division of Preventive Medicine and Epidemiology, Tohoku University Tohoku Medical Megabank Organization, Sendai, Miyagi 980-8573, Japan;
- Division of Molecular Epidemiology, Environment and Genome Research Center, Graduate School of Medicine, Tohoku University, Sendai, Miyagi 980-8573, Japan
- Department of Pharmaceutical Sciences, Tohoku University Hospital, Sendai, Miyagi 980-8574, Japan; (G.O.); (N.M.)
- Correspondence: ; Tel.: +81-22-717-8104; Fax: +81-22-717-8106
| | - Nariyasu Mano
- Department of Pharmaceutical Sciences, Tohoku University Hospital, Sendai, Miyagi 980-8574, Japan; (G.O.); (N.M.)
- Laboratory of Clinical Pharmacy, Tohoku University Graduate School of Pharmaceutical Sciences, Sendai, Miyagi 980-8574, Japan;
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9
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Noda A, Sakai T, Obara T, Miyazaki M, Tsuchiya M, Oyanagi G, Murai Y, Mano N. Characteristics of pediatric adverse drug reaction reports in the Japanese Adverse Drug Event Report Database. BMC Pharmacol Toxicol 2020; 21:36. [PMID: 32448369 PMCID: PMC7245855 DOI: 10.1186/s40360-020-00412-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2019] [Accepted: 05/12/2020] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND There are no reports on investigations of the characteristics of adverse drug reaction (ADR) reports for pediatric patients in the Japanese Adverse Drug Event Report database (JADER) and the utility of database for drug safety surveillance in these patients. METHOD We aimed to evaluate ADR reports for pediatric patients in the JADER. We used spontaneous ADR reports included in the JADER since April 1, 2004, to December 31, 2017, which was downloaded in April 2018. In a total of 504,407 ADR reports, the number of spontaneous reports was 386,400 (76.6%), in which 37,534 (7.4%) were unknown age reports. After extraction of 27,800 ADR reports for children aged < 10 and 10-19 years, we excepted for ADR reports associated with a vaccine (n = 6355) and no-suspected drug reports (n = 86). A total of 21,359 (4.2%) reports were finally included in this analysis. RESULTS More than half of the ADR reports were for children aged < 10 years. Approximately 30% of ADR reports had multiple suspected drugs, which did not differ by age. The percentages of fatal outcomes of ADRs among patients aged < 10 and 10-19 years were 4.7 and 3.9%, respectively. The most frequently reported drug, reaction, and drug-reaction pair were oseltamivir, abnormal behavior, and oseltamivir and abnormal behavior, respectively. CONCLUSION We clarified the characteristics of ADR reports for Japanese children by using the JADER. ADR report databases, especially those for pediatric patients, are valuable pharmacovigilance tools in Japan and other countries. Therefore, a proper understanding of the characteristics of the ADR reports in the JADER is important. Additionally, potential signals for ADRs in pediatric patients should be monitored continuously and carefully.
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Affiliation(s)
- Aoi Noda
- Division of Preventive Medicine and Epidemiology, Tohoku University Tohoku Medical Megabank Organization, Sendai, Miyagi, Japan.,Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan.,Department of Pharmaceutical Sciences, Tohoku University Hospital, Sendai, Miyagi, Japan
| | - Takamasa Sakai
- Drug Informatics, Faculty of Pharmacy, Meijo University, Nagoya, Aichi, Japan
| | - Taku Obara
- Division of Preventive Medicine and Epidemiology, Tohoku University Tohoku Medical Megabank Organization, Sendai, Miyagi, Japan. .,Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan. .,Department of Pharmaceutical Sciences, Tohoku University Hospital, Sendai, Miyagi, Japan.
| | - Makoto Miyazaki
- Laboratory of Clinical Pharmacy, Tohoku University Graduate School of Pharmaceutical Sciences, Sendai, Miyagi, Japan
| | - Masami Tsuchiya
- Laboratory of Clinical Pharmacy, Tohoku University Graduate School of Pharmaceutical Sciences, Sendai, Miyagi, Japan.,Department of Pharmacy, Miyagi Cancer Center, Natori, Miyagi, Japan
| | - Gen Oyanagi
- Department of Pharmaceutical Sciences, Tohoku University Hospital, Sendai, Miyagi, Japan
| | - Yuriko Murai
- Department of Clinical Pharmaceutics, Tohoku Medical and Pharmaceutical University, Sendai, Miyagi, Japan
| | - Nariyasu Mano
- Department of Pharmaceutical Sciences, Tohoku University Hospital, Sendai, Miyagi, Japan.,Laboratory of Clinical Pharmacy, Tohoku University Graduate School of Pharmaceutical Sciences, Sendai, Miyagi, Japan
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10
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Spontaneous adverse drug reaction reports on patients with cirrhosis: analysis of the nature, quantity and quality of the reports. Eur J Clin Pharmacol 2020; 76:741-743. [DOI: 10.1007/s00228-020-02845-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Accepted: 02/07/2020] [Indexed: 10/25/2022]
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11
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Reconsidering clinical pharmacology frameworks as a necessary strategy for improving the health care of patients: a systematic review. Eur J Clin Pharmacol 2018; 74:1663-1670. [PMID: 30008120 DOI: 10.1007/s00228-018-2511-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2018] [Accepted: 06/22/2018] [Indexed: 10/28/2022]
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Waitt C, Low N, Van de Perre P, Lyons F, Loutfy M, Aebi-Popp K. Does U=U for breastfeeding mothers and infants? Breastfeeding by mothers on effective treatment for HIV infection in high-income settings. Lancet HIV 2018; 5:e531-e536. [PMID: 29960731 DOI: 10.1016/s2352-3018(18)30098-5] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2018] [Revised: 04/30/2018] [Accepted: 05/02/2018] [Indexed: 12/01/2022]
Abstract
Can the campaign Undetectable=Untransmittable (U=U), established for the sexual transmission of HIV, be applied to the transmission of HIV through breastfeeding? European AIDS Clinical Society and, to some extent, American guidelines now state that mothers with HIV who wish to breastfeed should be supported, with increased clinical and virological monitoring. This Viewpoint summarises existing evidence on transmission of HIV through breastfeeding, differences in HIV dynamics and viral load between breastmilk and plasma, and the effects of antiretroviral therapy on infants. At present, insufficient evidence exists to make clear recommendations for the required frequency of clinical and virological monitoring for mother and infant in a breastfeeding relationship or for the action to be taken in the event of viral rebound. We propose a roadmap for collaborative research to provide the missing evidence required to enable mothers who wish to breastfeed to make a fully informed choice.
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Affiliation(s)
- Catriona Waitt
- Department of Molecular and Clinical Pharmacology, University of Liverpool, Liverpool, UK; Infectious Diseases Institute, Makerere University College of Health Sciences, Kampala, Uganda; Royal Liverpool University Hospital, Liverpool, UK.
| | - Nicola Low
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | - Philippe Van de Perre
- Pathogenesis and Control of Chronic Infections, INSERM, University of Montpellier, Etablissement Français du Sang, CHU Montpellier, Montpellier, France
| | - Fiona Lyons
- Department of Genitourinary Medicine and Infectious Diseases, St James's Hospital, Dublin, Ireland
| | - Mona Loutfy
- Women's College Research Institute, Women's College Hospital, Toronto, ON, Canada; Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - Karoline Aebi-Popp
- Department of Infectious Diseases, Bern University Hospital, University of Bern, Bern, Switzerland
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McWilliam SJ, Hawcutt DB. Solving the problem of dose optimization of children’s medicines. Expert Rev Clin Pharmacol 2018; 11:205-208. [DOI: 10.1080/17512433.2018.1431528] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
- Stephen J. McWilliam
- Department of Nephrology, Alder Hey Children’s Hospital, Liverpool, UK
- Department of Women’s and Children’s Health, University of Liverpool, Liverpool, UK
| | - Daniel B. Hawcutt
- Department of Women’s and Children’s Health, University of Liverpool, Liverpool, UK
- NIHR Alder Hey Clinical Research Facility, Alder Hey Children’s Hospital, Liverpool, UK
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Hawcutt DB, Russell NJ, Maqsood H, Kouranloo K, Gomberg S, Waitt C, Sharp A, Riordan A, Turner MA. Spontaneous adverse drug reaction reports for neonates and infants in the UK 2001-2010: content and utility analysis. Br J Clin Pharmacol 2016; 82:1601-1612. [PMID: 27597136 DOI: 10.1111/bcp.13067] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2016] [Revised: 07/06/2016] [Accepted: 07/13/2016] [Indexed: 11/28/2022] Open
Abstract
AIMS The UK Medicines and Healthcare products Regulatory Agency (MHRA) runs a national spontaneous reporting system (Yellow Card [YC] Scheme) to collect 'suspected' adverse drug reaction (ADR) data. We aim to describe the content and utility of YC reports received for patients aged <2 years. METHODS Data on all ADRs reported using YC in infants aged <2 years from the years 2001-10 were supplied by the MHRA. RESULTS For infants age <2 years, 3496 suspected ADRs were reported using YC (paternal medication pre-conception n = 3, transplacental n = 246, transmammary n = 30, neonates n = 97, infant n = 477, and vaccinations n = 2673), averaging 0.96 YC per day. There was a male preponderance (male 49.1%, female 44.4%, unknown 6.5%), and only 34 (1.0%) of YC reports stated a gestational age. The medications most frequently reported were: transplacental and transmammary (fluoxetine, n = 21 and n = 4 respectively), neonate (swine flu vaccine, n = 8) infant (oseltamivir, n = 37) and vaccines (meningococcal vaccine, n = 693). Paternal, transmammary, neonatal and infant YC did not reflect clinical concerns raised by the UK regulator. Transplacental and vaccination reports did correlate with some of the changes in practice and clinical alerts received. CONCLUSIONS The frequency of YC reports for those <2 years is low, neonates are poorly represented, and recording of gestational age is poor. With the exception of vaccinations, spontaneous reports alone are not currently generating the data required, and important safety messages from the regulator do not match reporting patterns. Additional reporting strategies are required to improve the quantity and quality of suspected ADR data in young children.
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Affiliation(s)
- Daniel B Hawcutt
- Department of Women's and Children's Health, University of Liverpool.,NIHR Alder Hey Clinical Research Facility.,Alder Hey Children's Hospital, Liverpool
| | | | | | | | | | - Catriona Waitt
- Department of Molecular and Clinical Pharmacology, University of Liverpool
| | - Andrew Sharp
- Department of Women's and Children's Health, University of Liverpool.,Liverpool Women's NHS Foundation Trust, Liverpool
| | | | - Mark A Turner
- Department of Women's and Children's Health, University of Liverpool.,Liverpool Women's NHS Foundation Trust, Liverpool
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