血小板生成素相关药物与血栓栓塞事件的关联:孟德尔随机化和真实世界研究

IF 3.4 3区 医学 Q2 PHARMACOLOGY & PHARMACY
Cuilv Liang, Qiying Chen, Yin Zhang
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引用次数: 0

摘要

研究表明,使用促血小板生成素相关药物(TPORD)治疗血栓栓塞事件(TEEs)的结果相互矛盾。我们的研究旨在探讨 TPORD 与 TEE 之间的相关性。研究采用药物靶向孟德尔随机化(MR)和多变量 MR(MVMR)分析来探讨 TPORD 与静脉血栓栓塞(VTE)、深静脉血栓(DVT)、肺栓塞(PE)、心肌梗死(MI)和缺血性中风(STR)等 TEE 之间的因果关系。同时,为了进一步验证我们的研究结果,我们还从 AERSMine 中包含的 FDA 不良事件报告系统数据库中提取了不良事件(AEs),开展了一项真实世界研究。在药物目标 MR 中,TPORDs 与 VTE(OR = 1.193,95% 置信区间(CI):1.001-1.423,p = 0.049]、DVT(OR = 1.321,95% CI:1.027-1.700,p = 0.030)、MI(OR = 1.216,95% CI:1.010-1.464,p = 0.039)、STR(OR = 1.224,95% CI:1.021-1.468,p = 0.029)相关。在 MVMR 中,VTE/DVT/STR 保持稳定(VTE:OR = 1.3,95% CI:1.187-1.422,p <0.001;DVT:OR=1.465,95% CI:1.285-1.671,p<0.001;STR:OR=1.119,95% CI:1.018-1.229,p=0.019)和真实世界研究[比例报告比(ROR)下限大于 1]。在 MVMR(OR = 0.996,95% CI:0.894-1.109,p = 0.942)和真实世界研究(ROR 下限小于 1)中,心肌梗死的意义消失了。没有证据表明 TPORD 与 PE 之间存在因果关系(OR = 1.244,95% CI:0.969-1.597,p = 0.087),但它在真实世界研究中产生了信号(ROR 下限大于 1)。这项研究表明,TPORD 可能与 TEE 风险增加有关,尤其是导致 VTE/DVT/STR 的 AE。此外,TPORDs 与 PE/MI 之间的关系还有待商榷,需要进行更多的研究。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Association of thrombopoietin-related drugs with thromboembolic events: Mendelian randomization and a real-world study
Studies have shown conflicting results when using thrombopoietin-related drugs (TPORD) for thromboembolic events (TEEs). Our study aimed to explore the correlation between TPORDs and TEEs. Drug-targeted Mendelian randomization (MR) and multivariate MR (MVMR) analysis were used to explore the causal relationship between TPORDs and TEEs such as venous thromboembolism (VTE), deep vein thrombosis (DVT), pulmonary embolism (PE), myocardial infarction (MI) and ischemic stroke (STR). At the same time, a real-world study was conducted by extracting adverse events (AEs) from the FDA Adverse Event Reporting System database included in AERSMine to further validate our findings. In drug-target MR, TPORDs were associated with VTE (OR = 1.193, 95% confidence interval (CI): 1.001–1.423, p = 0.049], DVT (OR = 1.321, 95% CI: 1.027–1.700, p = 0.030), MI (OR = 1.216, 95% CI: 1.010–1.464, p = 0.039), STR (OR = 1.224, 95% CI: 1.021–1.468, p = 0.029). VTE/DVT/STR remained stable in MVMR (VTE: OR = 1.3, 95% CI: 1.187–1.422, p < 0.001; DVT: OR = 1.465,95% CI:1.285–1.671, p < 0.001; STR: OR = 1.119, 95% CI: 1.018–1.229, p = 0.019) and real-world studies [lower bound of proportional reporting ratio (ROR) greater than 1]. The significance of myocardial infarction disappeared in MVMR (OR = 0.996, 95% CI: 0.894–1.109, p = 0.942) and in real-world studies (lower ROR lower than 1). There was no evidence of a causal relationship between TPORD and PE (OR = 1.244, 95% CI: 0.969-1.597, p = 0.087), but it generated a signal from a real-world study (lower bound of ROR greater than 1). This study suggests that TPORDs may be associated with an increased risk of TEEs, particularly AEs leading to VTE/DVT/STR. In addition, the relationship between TPORDs and PE/MI is debatable and requires more research.
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来源期刊
Therapeutic Advances in Drug Safety
Therapeutic Advances in Drug Safety Medicine-Pharmacology (medical)
CiteScore
6.70
自引率
4.50%
发文量
31
审稿时长
9 weeks
期刊介绍: Therapeutic Advances in Drug Safety delivers the highest quality peer-reviewed articles, reviews, and scholarly comment on pioneering efforts and innovative studies pertaining to the safe use of drugs in patients. The journal has a strong clinical and pharmacological focus and is aimed at clinicians and researchers in drug safety, providing a forum in print and online for publishing the highest quality articles in this area. The editors welcome articles of current interest on research across all areas of drug safety, including therapeutic drug monitoring, pharmacoepidemiology, adverse drug reactions, drug interactions, pharmacokinetics, pharmacovigilance, medication/prescribing errors, risk management, ethics and regulation.
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