FOLFOX方案和FOLFIRI方案致肝毒性的安全信号挖掘

周阳云; 郭澄; 韩永龙

doi:10.6039/j.issn.1001-0408.2023.06.13

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FOLFOX方案和FOLFIRI方案致肝毒性的安全信号挖掘

药物与临床 | 更新时间：2023-03-24

- FOLFOX方案和FOLFIRI方案致肝毒性的安全信号挖掘
- Safety signal mining of FOLFOX scheme and FOLFIRI scheme-induced hepatotoxicity
- 中国药房 2023年34卷第6期页码：710-713
- 作者机构：
  
  上海交通大学医学院附属第六人民医院药剂科，上海　200233
- 作者简介：
  
  主管药师，硕士。研究方向：临床药学。电话：021-38297199。E-mail：zhouyangyun945@163.com
  主任药师，教授，博士生导师，博士。研究方向：临床药学。电话：021-38297199。E-mail：yonglongh@126.com
- 基金信息：
  
  上海市科技计划项目(20ZR1442400);上海市浦东新区卫生健康委员会卫生科技项目(PW2021E-03)
- DOI：10.6039/j.issn.1001-0408.2023.06.13
  中图分类号： R969.3;R979.1
- 纸质出版日期：2023-03-30，
  
  收稿日期：2022-09-13，
  
  修回日期：2023-02-04，
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周阳云,郭澄,韩永龙.FOLFOX方案和FOLFIRI方案致肝毒性的安全信号挖掘 ^Δ[J].中国药房,2023,34(06):710-713.

ZHOU Yangyun,GUO Cheng,HAN Yonglong.Safety signal mining of FOLFOX scheme and FOLFIRI scheme-induced hepatotoxicity[J].ZHONGGUO YAOFANG,2023,34(06):710-713.
周阳云,郭澄,韩永龙.FOLFOX方案和FOLFIRI方案致肝毒性的安全信号挖掘 ^Δ[J].中国药房,2023,34(06):710-713. DOI： 10.6039/j.issn.1001-0408.2023.06.13.

ZHOU Yangyun,GUO Cheng,HAN Yonglong.Safety signal mining of FOLFOX scheme and FOLFIRI scheme-induced hepatotoxicity[J].ZHONGGUO YAOFANG,2023,34(06):710-713. DOI： 10.6039/j.issn.1001-0408.2023.06.13.

摘要

目的

挖掘FOLFOX方案和FOLFIRI方案致肝毒性的安全信号，为临床合理治疗方案的选择、药品不良反应（ADR）的防治提供参考。

方法

利用报告比值比法和比例报告比值法对美国FDA药品不良事件报告系统中2004年1月1日至2022年6月30日FOLFOX方案和FOLFIRI方案相关药品不良事件（ADE）报告进行分析，挖掘其致肝毒性的潜在安全信号。

结果

分别检索到FOLFOX方案和FOLFIRI方案相关ADE报告3 454、1 359份，涉及男、女性患者比例分别为1.50∶1、1.67∶1；上报数排名前5位的国家均为美国、日本、法国、意大利、英国，其报告总和分别占各自报告总数的58.48%和53.79%。有超过90%的患者合并用药不超过5种，FOLFOX方案和FOLFIRI方案联合抗血管生成药物或表皮生长因子受体抑制剂的患者比例分别为45.45%和86.82%。FOLFOX方案致肝毒性相关ADE报告有443份，ADR信号共22个，包括肝窦阻塞综合征、结节状再生增生、药物诱导的肝损伤、血胆红素升高等；FOLFIRI方案肝毒性相关ADE报告有128份，ADR信号共9个，包括血胆红素升高、肝毒性、脂肪性肝炎、肝脂肪变性等。

结论

FOLFOX方案和FOLFIRI方案所致肝毒性类型不同，临床应加强用药监护，保障患者用药安全。

Abstract

OBJECTIVE

To mine the safety signals of FOLFOX scheme and FOLFIRI scheme-induced hepatotoxicity， and to provide reference for the selection of clinical rational treatment plan and the prevention and treatment of drug adverse reaction （ADR）.

METHODS

Reporting odds ratio method and proportion report ratio method were used to analyze adverse drug event （ADE） reports of FOLFOX scheme and FOLFIRI scheme in FDA adverse event reporting system during January 1， 2004-June 30， 2022. The potential safety signals of FOLFOX scheme and FOLFIRI scheme-induced hepatotoxicity were mined.

RESULTS

The amounts of ADE reports related to FOLFOX scheme and FOLFIRI scheme were respectively 3 454 and 1 359； the proportions of male and female patients involved were 1.50∶1 and 1.67∶1 in these two schemes， respectively. The top five countries with the largest number of reports were the United States， Japan， France， Italy and the United Kingdom， respectively accounting for 58.48% and 53.79% of the total reported cases. More than 90% of patients took no more than 5 drugs in combination， the proportion of patients receiving FOLFOX scheme and FOLFIRI scheme combined with anti-angiogenic drugs or epidermal growth factor receptor inhibitors was 45.45% and 86.82%， respectively. Totally 443 ADE reports of FOLFOX scheme-induced hepatotoxicity were collected， and 22 ADR signals were generated， including hepatic sinusoidal obstruction syndrome， nodular regenerative hyperplasia， drug-induced liver injury， blood bilirubin increased， etc. Totally 128 ADE reports of FOLFIRI scheme-induced hepatotoxicity were reported， and 9 ADR signals were generated， including blood bilirubin increased， hepatotoxicity， steatohepatitis， hepatic steatosis， etc.

CONCLUSIONS

FOLFOX scheme and FOLFIRI scheme can cause different types of hepatotoxicity. Clinical drug monitoring should be strengthened to guarantee drug safety.

关键词

FOLFOX方案FOLFIRI方案FAERS数据库肝毒性安全信号比例失衡法

Keywords

FOLFIRI schemeFAERS databasehepatotoxicitysafety signalproportional imbalance method

references

ZHU C，REN X H，LIU D，et al. Oxaliplatin-induced hepatic sinusoidal obstruction syndrome[J]. Toxicology，2021，460：152882.

HAN J，ZHANG J，ZHANG C L. Irinotecan-induced steatohepatitis：current insights[J]. Front Oncol，2021，11：754891.

LU Q Y，ZHAO A L，DENG W，et al. Hepatic histopatho-logy and postoperative outcome after preoperative chemotherapy for Chinese patients with colorectal liver meta-stases[J]. World J Gastrointest Surg，2013，5（3）：30-36.

OVERMAN M J，MARU D M，CHARNSANGAVEJ C，et al. Oxaliplatin-mediated increase in spleen size as a biomarker for the development of hepatic sinusoidal injury[J]. J Clin Oncol，2010，28（15）：2549-2555.

张婧媛，白羽霞，韩晟，等. 数据挖掘方法检测药品不良反应信号的应用研究[J]. 药物不良反应杂志，2016，18（6）：412-416.

李苑雅，张艳，沈爱宗. 基于自发呈报系统药品不良反应信号检测方法的研究进展[J]. 安徽医药，2015，19（7）：1233-1236.

SAKAEDA T，TAMON A，KADOYAMA K，et al. Data mining of the public version of the FDA Adverse Event Reporting System[J]. Int J Med Sci，2013，10（7）：796-803.

VIGANO L，DE ROSA G，TOSO C，et al. Reversibility of chemotherapy-related liver injury[J]. J Hepatol，2017，67（1）：84-91.

YANG S J，PENG R Z，ZHOU L M. The impact of hepatic steatosis on outcomes of colorectal cancer patients with liver metastases：a systematic review and meta-analysis[J]. Front Med （Lausanne），2022，9：938718.

PATHAK S，TANG J M，TERLIZZO M，et al. Hepatic steatosis，body mass index and long term outcome in patients undergoing hepatectomy for colorectal liver metastases[J]. Eur J Surg Oncol，2010，36（1）：52-57.

REISSFELDER C，BRAND K，SOBIEGALLA J，et al. Chemotherapy-associated liver injury and its influence on outcome after resection of colorectal liver metastases[J]. Surgery，2014，155（2）：245-254.

GANGI A，LU S C. Chemotherapy-associated liver injury in colorectal cancer[J]. Therap Adv Gastroenterol，2020，13：1756284820924194.

ROBINSON S M，WILSON C H，BURT A D，et al. Chemotherapy-associated liver injury in patients with colorectal liver metastases：a systematic review and meta-analysis[J]. Ann Surg Oncol，2012，19（13）：4287-4299.

DUELL P B，WELTY F K，MILLER M，et al. Nonalcoholic fatty liver disease and cardiovascular risk：a scientific statement from the American Heart Association[J]. Arterioscler Thromb Vasc Biol，2022，42（6）：e168-e185.

OVERMAN M J，FERRAROTTO R，RAGHAV K，et al. The addition of bevacizumab to oxaliplatin-based chemotherapy：impact upon hepatic sinusoidal injury and throm-bocytopenia[J]. J Natl Cancer Inst，2018，110（8）：888-894.

IMAI K，EMI Y，IYAMA K I，et al. Splenic volume may be a useful indicator of the protective effect of bevacizumab against oxaliplatin-induced hepatic sinusoidal obstruction syndrome[J]. Eur J Surg Oncol，2014，40（5）：559-566.

VOLK A M，FRITZMANN J，REISSFELDER C，et al. Impact of bevacizumab on parenchymal damage and functional recovery of the liver in patients with colorectal liver metastases[J]. BMC Cancer，2016，16：84.

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