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Fortuny J, von Gersdorff G, Lassalle R, Linder M, Overbeek J, Reinold J, Toft G, Timmer A, Dress J, Blin P, Droz-Perroteau C, Ehrenstein V, Franzoni C, Herings R, Kollhorst B, Moore N, Odsbu I, Perez-Gutthann S, Schink T, Rascher K, Rasouliyan L, Rothman KJ, Saigi-Morgui N, Schaller M, Smits E, Forstner M, Bénichou J, Bircher AJ, Garbe E, Rampton DS, Gutierrez L. Use of intravenous iron and risk of anaphylaxis: A multinational observational post-authorisation safety study in Europe. Pharmacoepidemiol Drug Saf 2021; 30:1447-1457. [PMID: 34181291 PMCID: PMC8457074 DOI: 10.1002/pds.5319] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Revised: 06/18/2021] [Accepted: 06/24/2021] [Indexed: 11/11/2022]
Abstract
PURPOSE This post-authorisation safety study estimated the risk of anaphylaxis in patients receiving intravenous (IV) iron in Europe, with interest in iron dextran and iron non-dextrans. Studies conducted in the United States have reported risk of anaphylaxis to IV iron ranging from 2.0 to 6.8 per 10 000 first treatments. METHODS Cohort study of IV iron new users, captured mostly through pharmacy ambulatory dispensing, from populations covered by health and administrative data sources in five European countries from 1999 to 2017. Anaphylaxis events were identified through an algorithm that used parenteral penicillin as a positive control. RESULTS A total of 304 210 patients with a first IV iron treatment (6367 iron dextran), among whom 13-16 anaphylaxis cases were identified and reported as a range to comply with data protection regulations. The pooled unadjusted incidence proportion (IP) ranged from 0.4 (95% confidence interval [CI], 0.2-0.9) to 0.5 (95% CI, 0.3-1.0) per 10 000 first treatments. No events were identified at first dextran treatments. There were 231 294 first penicillin treatments with 30 potential cases of anaphylaxis (IP = 1.2; 95% CI, 0.8-1.7 per 10 000 treatments). CONCLUSION We found an IP of anaphylaxis from 0.4 to 0.5 per 10 000 first IV iron treatments. The study captured only a fraction of IV iron treatments administered in hospitals, where most first treatments are likely to happen. Due to this limitation, the study could not exclude a differential risk of anaphylaxis between iron dextran and iron non-dextrans. The IP of anaphylaxis in users of penicillin was consistent with incidences reported in the literature.
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Affiliation(s)
- Joan Fortuny
- Pharmacoepidemiology and Risk Management, RTI Health Solutions, Barcelona, Spain
| | - Gero von Gersdorff
- Department of Internal Medicine-QiN-group, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Régis Lassalle
- Bordeaux PharmacoEpi, INSERM CIC1401, University of Bordeaux, Bordeaux, France
| | - Marie Linder
- Centre for Pharmacoepidemiology, Karolinska Institutet, Stockholm, Sweden
| | - Jetty Overbeek
- Department Research, PHARMO Institute for Drug Outcomes Research, Utrecht, The Netherlands
| | - Jonas Reinold
- Clinical Epidemiology Group, Leibniz Institute for Prevention Research and Epidemiology-BIPS, Bremen, Germany
| | - Gunnar Toft
- Department of Clinical Epidemiology, Aarhus University, Aarhus, Denmark
| | - Antje Timmer
- Epidemiology and Biometry Group, Carl von Ossietzky University Oldenburg, Oldenburg, Germany
| | - Jochen Dress
- Research Data Center (DaTraV), Federal Institute for Drugs and Medical Devices-BfArM, Bonn, Germany
| | - Patrick Blin
- Bordeaux PharmacoEpi, INSERM CIC1401, University of Bordeaux, Bordeaux, France
| | | | - Vera Ehrenstein
- Department of Clinical Epidemiology, Aarhus University, Aarhus, Denmark
| | - Carla Franzoni
- Pharmacoepidemiology and Risk Management, RTI Health Solutions, Barcelona, Spain
| | - Ron Herings
- Department Research, PHARMO Institute for Drug Outcomes Research, Utrecht, The Netherlands.,Amsterdam UMC, Vrije Universiteit Amsterdam, Epidemiology and Biostatistics, Amsterdam, The Netherlands
| | - Bianca Kollhorst
- Clinical Epidemiology Group, Leibniz Institute for Prevention Research and Epidemiology-BIPS, Bremen, Germany
| | - Nicholas Moore
- Bordeaux PharmacoEpi, INSERM CIC1401, University of Bordeaux, Bordeaux, France
| | - Ingvild Odsbu
- Centre for Pharmacoepidemiology, Karolinska Institutet, Stockholm, Sweden
| | | | - Tania Schink
- Clinical Epidemiology Group, Leibniz Institute for Prevention Research and Epidemiology-BIPS, Bremen, Germany
| | - Katherine Rascher
- Department of Internal Medicine-QiN-group, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Lawrence Rasouliyan
- Pharmacoepidemiology and Risk Management, RTI Health Solutions, Barcelona, Spain
| | - Kenneth J Rothman
- Pharmacoepidemiology and Risk Management, RTI Health Solutions, Waltham, Massachusetts, USA
| | - Nuria Saigi-Morgui
- Pharmacoepidemiology and Risk Management, RTI Health Solutions, Barcelona, Spain
| | - Mathias Schaller
- Department of Internal Medicine-QiN-group, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Elisabeth Smits
- Department Research, PHARMO Institute for Drug Outcomes Research, Utrecht, The Netherlands
| | | | | | - Jacques Bénichou
- Department of Biostatistics, Rouen University Hospital and Inserm U 1018, University of Rouen, Rouen, France
| | - Andreas J Bircher
- Allergy Unit, Dermatology Clinic University Hospital Basel, Basel, Switzerland.,Faculty of Biomedicine, Università della Svizzera italiana, Lugano, Switzerland
| | - Edeltraut Garbe
- Clinical Epidemiology Group, Leibniz Institute for Prevention Research and Epidemiology-BIPS, Bremen, Germany
| | - David S Rampton
- Department of Gastroenterology, Royal London Hospital, London, UK
| | - Lia Gutierrez
- Pharmacoepidemiology and Risk Management, RTI Health Solutions, Barcelona, Spain
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Stäubert S, Weber U, Michalik C, Dress J, Ngouongo S, Stausberg J, Winter A. Modeling Requirements for Cohort and Register IT. Stud Health Technol Inform 2016; 228:277-281. [PMID: 27577387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
BACKGROUND The project KoRegIT (funded by TMF e.V.) aimed to develop a generic catalog of requirements for research networks like cohort studies and registers (KoReg). The catalog supports such kind of research networks to build up and to manage their organizational and IT infrastructure. OBJECTIVES To make transparent the complex relationships between requirements, which are described in use cases from a given text catalog. By analyzing and modeling the requirements a better understanding and optimizations of the catalog are intended. There are two subgoals: a) to investigate one cohort study and two registers and to model the current state of their IT infrastructure; b) to analyze the current state models and to find simplifications within the generic catalog. METHODS Processing the generic catalog was performed by means of text extraction, conceptualization and concept mapping. Then methods of enterprise architecture planning (EAP) are used to model the extracted information. To work on objective a) questionnaires are developed by utilizing the model. They are used for semi-structured interviews, whose results are evaluated via qualitative content analysis. Afterwards the current state was modeled. Objective b) was done by model analysis. RESULTS A given generic text catalog of requirements was transferred into a model. As result of objective a) current state models of one existing cohort study and two registers are created and analyzed. An optimized model called KoReg-reference-model is the result of objective b). CONCLUSION It is possible to use methods of EAP to model requirements. This enables a better overview of the partly connected requirements by means of visualization. The model based approach also enables the analysis and comparison of the empirical data from the current state models. Information managers could reduce the effort of planning the IT infrastructure utilizing the KoReg-reference-model. Modeling the current state and the generation of reports from the model, which could be used as requirements specification for bids, is supported, too.
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Affiliation(s)
- Sebastian Stäubert
- Institute for Medical Informatics, Statistics and Epidemiology (IMISE), Leipzig University, Germany
| | - Ulrike Weber
- Department of Computer Science, Leipzig University, Germany
| | - Claudia Michalik
- Competence Network for HIV/AIDS (KompNet), Ruhr-University Bochum, Germany
| | - Jochen Dress
- German Institute of Medical Documentation and Information, Cologne, Germany
| | | | - Jürgen Stausberg
- Institute for Medical Informatics, Biometry and Epidemiology, University Duisburg-Essen, Germany
| | - Alfred Winter
- Institute for Medical Informatics, Statistics and Epidemiology (IMISE), Leipzig University, Germany
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Michalik C, Dress J, Ngouongo S, Stäubert S, Weber U, Brockmeyer N, Paulus U, Stausberg J. Requirements and tasks of cohorts and registers, the German KoRegIT project. Stud Health Technol Inform 2014; 205:1085-1089. [PMID: 25160356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Epidemiological cohorts and registers (KoReg) are long lasting and complex research projects, which need systematic and extensive planning and steering. The aim of the KoRegIT project was to develop a generic catalogue of requirements to support the organisational- and IT-structure of KoReg. The catalogue of requirements comprises the top level (TL) tasks of the core processes. All TL were classified into the following project phases: 1. Development, 2. Operation, 3. Completion. According to the defined TL tasks, the appropriate use cases (UC) were identified. The catalogue currently specifies 45 TL tasks and 207 UC. The UC were elaborated by a short and standardized description of the task, the involved actors (human or external systems), the preconditions, which have to be fulfilled in order to realize this task, the normal flow of the task and the post conditions. The developed catalogue was reviewed by representatives of different KoReg in Germany. The draft catalogue of requirements was revised according to the reviewer's feedback and discussion. The revised and complete catalogue with all elaborated UC was reviewed again by further experts. The developed KoRegIT catalogue of requirements offers a supporting tool to set-up the organisational structures and processes of KoReg as well as the definition of the needed IT-infrastructure. In addition it can be used to optimize or to expand these structures.
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Affiliation(s)
- Claudia Michalik
- Competence Network for HIV/AIDS (KompNet), Ruhr-University Bochum, Germany
| | - Jochen Dress
- Clinical Trial Centre (ZKS), University Cologne, Germany
| | - Sylvie Ngouongo
- Institute for Medical Information Processing, Biometry and Epidemiology (IBE), Ludwig-Maximilians-Universität Munich, Germany
| | - Sebastian Stäubert
- Institute for Medical Informatics, Statistics und Epidemiology (IMISE), University Leipzig, Germany
| | - Ulrike Weber
- Institute for Medical Informatics, Statistics und Epidemiology (IMISE), University Leipzig, Germany
| | - Norbert Brockmeyer
- Competence Network for HIV/AIDS (KompNet), Ruhr-University Bochum, Germany
| | - Ursula Paulus
- Clinical Trial Centre (ZKS), University Cologne, Germany
| | - Jürgen Stausberg
- Institute for Medical Information Processing, Biometry and Epidemiology (IBE), Ludwig-Maximilians-Universität Munich, Germany
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