与可逆性脑血管收缩综合征有关的药物:vigiBase®中的药物警戒研究。

IF 5 2区 医学 Q1 CLINICAL NEUROLOGY
Sylvie Favrelière, Julien Mahé, Gwenaelle Veyrac, Jean Philippe Neau, Claire Lafay-Chebassier, Marie Christine Pérault-Pochat
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引用次数: 0

摘要

背景:有关药物诱导的可逆性脑血管收缩综合征(RCVS)的数据很少。我们的目的是描述以前确定与 RCVS 有关的药物的 RCVS 特征,并调查与其他药物有关的潜在信号:查询了 VigiBase® 中截至 2023 年 5 月 31 日的所有 RCVS 报告。对已知可诱发 RCVS 的药物类别报告进行了描述性研究。为确定新药,进行了比例失调分析:结果:共纳入 560 份报告。RCVS发生在45-64岁(40%)和18-44岁(35%)的患者中,主要是女性(72.5%)。药物包括抗抑郁药(38.4%)、三苯氧胺(6.4%)、鼻减充血剂(3.7%)和免疫抑制剂(8.7%)。在50例病例中,抗抑郁药与已知可诱发RCVS的药物同时使用。抗抑郁药的中位发病时间为 195 天,而曲坦类药物、鼻腔减充血剂和免疫抑制剂的中位发病时间要短得多(1-10 天)。87%的病例预后良好,4.4%的病例死亡。我们发现有14种药物的比例失调信号:糖皮质激素、布丙酚、伐尼克兰、霉酚酸、阿立哌唑、曲唑酮、单克隆抗体(艾瑞那单抗、乌斯特库单抗和托珠单抗)、利普瑞林和阿那曲唑:本研究证实了血管收缩剂在 RCVS 发病中的作用,尤其是在联合使用时,并发现了潜在的信号,这可能有助于临床医生预见 RCVS 的先天性病因。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Drugs associated with reversible cerebral vasoconstriction syndrome: A pharmacovigilance study in vigiBase®.

Background: Data on drug-induced reversible cerebral vasoconstriction syndrome (RCVS) are scarce. We aimed to describe RCVS characteristics with drugs previously identified as associated with RCVS and investigate potential signals related to other drugs.

Methods: VigiBase® was queried for all reports of RCVS until 31 May 2023. A descriptive study was performed on reports concerning drug classes known to precipitate RCVS. To identify new drugs, a disproportionality analysis was conducted.

Results: In total, 560 reports were included. RCVS occurred in patients aged between 45-64 years (40%) and 18-44 years (35%), mainly in females (72.5%). Drugs were antidepressants (38.4%), triptans (6.4%), nasal decongestants (3.7%) and immunosupressants (8.7%). In 50 cases, antidepressants were in association with drugs known to precipitate RCVS. The median time to onset was 195 days for antidepressants and much shorter (1-10 days) for triptans, nasal decongestants and immunosuppressants. The outcome was favorable in 87% of cases, and fatal in 4.4%. We found a disproportionality signal with 14 drugs: glucocorticoids, bupropion, varenicline, mycophenolic acid, aripiprazole, trazodone, monoclonal antibodies (erenumab, ustekinumab and tocilizumab), leuprorelin and anastrozole.

Conclusions: The present study confirms the role of vasoconstrictors in the onset of RCVS, particularly when used in combination and found potential signals, which may help clinicians envisage an iatrogenic etiology of RCVS.

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来源期刊
Cephalalgia
Cephalalgia 医学-临床神经学
CiteScore
10.10
自引率
6.10%
发文量
108
审稿时长
4-8 weeks
期刊介绍: Cephalalgia contains original peer reviewed papers on all aspects of headache. The journal provides an international forum for original research papers, review articles and short communications. Published monthly on behalf of the International Headache Society, Cephalalgia''s rapid review averages 5 ½ weeks from author submission to first decision.
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