Iran J Kidney Dis. 2022 Mar;16(2):96-107.

ABSTRACT

INTRODUCTION: The antioxidant activity of curcumin (CMN) has been evaluated in several studies. We aimed to examine the protective effect of curcumin on gentamicin-induced nephrotoxicity in rats, both at histological and immunohistochemical levels.

METHODS: Forty male Wistar albino rats were assigned into four groups of 10 as follows: group 1: control, group 2: curcumin for 15 days, group 3: gentamicin for the last 10 days, and group 4: curcumin for 15 days and gentamicin for the last 10 days. Curcumin (100 mg/kg/d) was gavaged, and gentamicin (80 mg/kg/d) was injected intraperitoneally. Kidney tissues and blood were collected for histological, immunohistochemical and biochemical studies. Body weight and kidney weight/body weight changes were recorded.

RESULTS: Gentamicin nephrotoxicity was characterized by a significant rise in serum urea and creatinine levels and a significant reduction in body weight and an increase in kidney weight/body weight. The gentamicin group showed degenerative changes in tubules and glomeruli together with, increased phosphorylated (p)-p38 mitogen-activated protein kinase (p38 MAPK) positive cells in immunohistochemical evaluation, increased immunoreactivity of nuclear factor-kappa B (NFkB), and decreased immunoreactivity of nuclear factor erythroid 2-related factor 2 (Nrf2). Curcumin diminished body weight loss caused by gentamicin administration but, did not change the kidney weight/body weight. Moreover, curcumin ameliorated the histological alterations and reduced the biochemical parameters. Additionaly, curcumin significantly decreased p-p38 MAPK positive cells and NFkB immunoreactivity, while significantly increasing Nrf2 immunoreactivity in the kidney tissue.

CONCLUSION: We conclude that curcumin may attenuate gentamicininduced nephrotoxicity by supprresing the p38 MAPK and NFkB, and activating the Nrf2 signaling pathways. DOI: 10.52547/ijkd.6647.

PMID:35489078

Vestn Oftalmol. 2022;138(2):94-99. doi: 10.17116/oftalma202213802194.

ABSTRACT

This article reviews information on possible adverse events occurring in the organ of vision - in particular, the retina - after using systemic drugs, discusses the drugs that lead to drug-induced retinopathy most often, and describes histomorphological changes and modern understanding of the pathogenesis of damage to retinal structures.

PMID:35488567 | DOI:10.17116/oftalma202213802194

BMJ Case Rep. 2022 Apr 29;15(4):e249141. doi: 10.1136/bcr-2022-249141.

ABSTRACT

A woman in her 40s with advanced bladder cancer was admitted to hospital with hypercalcaemia of malignancy. Initially, she presented with non-specific symptoms of malaise, fatigue and general deterioration. She was treated with intravenous fluids and zoledronic acid in order to bring her calcium levels down, but subsequently developed significant hypocalcaemia. This manifested as tetany in the hands in the form of bilateral carpopedal spasm. She also reported perioral paraesthesia. Bloods during her admission revealed deranged electrolytes, and her vitamin D level was on the lower scale of normal (25 nmol/L). The patient's symptoms improved with electrolyte replacement and oral baclofen for her symptomatically distressing wrist and hand muscle spasms. This case report is a reminder that bisphosphonates can cause significant hypocalcaemia with symptoms of tetany, even when they are given for initial hypercalcaemia. Baclofen worked well to improve symptoms.

PMID:35487644 | DOI:10.1136/bcr-2022-249141

Asian Pac J Cancer Prev. 2022 Apr 1;23(4):1263-1270. doi: 10.31557/APJCP.2022.23.4.1263.

ABSTRACT

According to the instructions of Iran's National Corona Response Committee in the Iranian Ministry of Health and Medical Education, patients undergoing treatments for their cancer are prioritized in Covid-19 vaccination. The present study was therefore conducted to investigate the toxicity and acute side-effects of a Covid-19 vaccine in cancer patients presenting to Medical Oncology Clinic of Kermanshah University of Medical Science. After excluding the patients with active infection and the recently-infected ones with Covid-19, they underwent the vaccination. The patients with cell counts exceeding 3,000 received two doses of the vaccine with a 21-day interval and treatment of their underlying disease was postponed for 7 days. The side-effects were mild and tolerable and included fever (case 10), pain at the injection site (7), dizziness (7), body pain (6), abdominal pain (6), myalgia (6), headache (6), chills (3), shortness of breath (3), diarrhea (1), runny nose (1) and dryness of the throat (1). No significant toxicity was reported in the patients who were safely vaccinated under the supervision of the medical oncology clinic.

PMID:35485684 | DOI:10.31557/APJCP.2022.23.4.1263

Clin Pharmacol Drug Dev. 2022 Apr 29. doi: 10.1002/cpdd.1102. Online ahead of print.

ABSTRACT

Misoprostol is a synthetic prostaglandin E1 derivative that has been used to treat duodenal and gastric ulcers, and to prevent ulcers caused by nonsteroidal anti-inflammatory drugs in many countries. Misoprostol can also be used for medical abortion. This study aimed to investigate the pharmacokinetic profiles of misoprostol tablets (test product) by comparing them with Cytotec (200 μg) (reference product). To assess the bioequivalence between test and reference products, a two-sequence, two-period crossover study was conducted with 48 healthy Chinese subjects enrolled under fasting conditions. A validated liquid chromatography-tandem mass spectrometry (LC-MS/MS) assay was used to determine the concentration of misoprostol acid in plasma. A mixed model analysis of variance was used to calculate the bioequivalence of pharmacokinetic (PK) parameters. The point estimate of geometric mean ratios with 90% confidence intervals for the maximum observed concentration (Cmax ) and the area under the concentration-time curve (AUC0-t ) for misoprostol acid in reference and test products were 107.8% and 106.5%, respectively (range 80%-125%). Additionally, none of the secondary PK parameters presented significant differences. No severe or more than moderate adverse events were detected in the 48 subjects. However, one subject discontinued the treatment due to drug-related gastrointestinal reactions. All adverse events were mild with rates of 19.2% and 22.9% after the administration test and reference products, respectively. Overall, the bioequivalence between the two misoprostol products was demonstrated in fasting conditions, and all subjects tolerated both treatments.

PMID:35486088 | DOI:10.1002/cpdd.1102

Sci Rep. 2022 Apr 28;12(1):6978. doi: 10.1038/s41598-022-10928-z.

ABSTRACT

Cardiovascular adverse conditions are caused by coronavirus disease 2019 (COVID-19) infections and reported as side-effects of the COVID-19 vaccines. Enriching current vaccine safety surveillance systems with additional data sources may improve the understanding of COVID-19 vaccine safety. Using a unique dataset from Israel National Emergency Medical Services (EMS) from 2019 to 2021, the study aims to evaluate the association between the volume of cardiac arrest and acute coronary syndrome EMS calls in the 16-39-year-old population with potential factors including COVID-19 infection and vaccination rates. An increase of over 25% was detected in both call types during January-May 2021, compared with the years 2019-2020. Using Negative Binomial regression models, the weekly emergency call counts were significantly associated with the rates of 1st and 2nd vaccine doses administered to this age group but were not with COVID-19 infection rates. While not establishing causal relationships, the findings raise concerns regarding vaccine-induced undetected severe cardiovascular side-effects and underscore the already established causal relationship between vaccines and myocarditis, a frequent cause of unexpected cardiac arrest in young individuals. Surveillance of potential vaccine side-effects and COVID-19 outcomes should incorporate EMS and other health data to identify public health trends (e.g., increased in EMS calls), and promptly investigate potential underlying causes.

PMID:35484304 | PMC:PMC9048615 | DOI:10.1038/s41598-022-10928-z

PLoS One. 2022 Apr 28;17(4):e0267673. doi: 10.1371/journal.pone.0267673. eCollection 2022.

ABSTRACT

BACKGROUND: The care of epileptic patients is complicated by the cognitive adverse effect of the drug, disease, pharmacokinetics, and pharmacodynamics properties of antiepileptic drugs which in turn intensify the risk of drug therapy problems among epileptic patients.

OBJECTIVE: To assess drug therapy problems and predicting factors among ambulatory epileptic patients at Jimma University Medical Center, Southwest Ethiopia, from September 2020 to May 2021.

METHODOLOGY: A hospital-based prospective observational study was conducted. A semi-structured questionnaire was used to collect data from patients as well as from charts. Drug therapy problems were identified using Cipolle's, Morley, and Strand drug therapy problem identification and classification method. Data were entered into Epi data manager version 4.6 and exported to statistical software package for social science version 23.0 for analysis. Multiplestepwise backward logistic regression analysis was carried out to identify predictors of drug therapy problems. The 95% CI was used to show an association between the dependent and independent variables. P-value < 0.05 was considered as statistically significant.

RESULTS: Of the total 320 epileptic patients 224(70.0%) patients had at least one drug therapy problem. A total of 395 drug therapy problems were identified among two hundred twenty-four patients with an average of 1.2 drug therapy problems per patient. The frequently identified drug therapy problems were non-compliance 115(29.11), adverse drug reaction 110(27.84%), and dose too low 103(26%). Getting of a drug by purchasing [AOR = 4.6,95%CI:(2.05-10.7)], poorly involvement of the patients in therapeutic decision making [AOR = 3.02,95%CI:(1.5-6.06)], the number of medications ≥ two [AOR = 5.3,95%CI:(1.2-22.9)] and having had uncontrolled seizure [AOR = 10.9,95%CI:(4.9-24.2)] were independent predictors of drug therapy problems.

CONCLUSIONS: Drug therapy problems were common among epileptic patients in the study area. Patients who were getting their drugs by purchasing, poorly involved in therapeutic decision making, having had an uncontrolled seizure, and taking two and above drugs were more likely to experience drug therapy problems. Therefore, due attention should be given to patients with the aforementioned problems to decrease the occurrence of drug therapy problems and improve overall outcomes among epileptic patients.

PMID:35482756 | PMC:PMC9049505 | DOI:10.1371/journal.pone.0267673

J Healthc Eng. 2022 Apr 25;2022:4584965. doi: 10.1155/2022/4584965. eCollection 2022.

ABSTRACT

SARS-CoV-2 is a recently discovered virus that poses an urgent threat to global health. The disease caused by this virus is termed COVID-19. Death tolls in different countries remain to rise, leading to continuous social distancing and lockdowns. Patients of different ages are susceptible to severe disease, in particular those who have been admitted to an ICU. Machine learning (ML) predictive models based on medical data patterns are an emerging topic in areas such as the prediction of liver diseases. Prediction models that combine several variables or features to estimate the risk of people being infected or experiencing a poor outcome from infection could assist medical staff in the treatment of patients, especially those that develop organ failure such as that of the liver. In this paper, we propose a model called the detecting model for liver damage (DMLD) that predicts the risk of liver damage in COVID-19 ICU patients. The DMLD model applies machine learning algorithms in order to assess the risk of liver failure based on patient data. To assess the DMLD model, collected data were preprocessed and used as input for several classifiers. SVM, decision tree (DT), Naïve Bayes (NB), KNN, and ANN classifiers were tested for performance. SVM and DT performed the best in terms of predicting illness severity based on laboratory testing.

PMID:35480158 | PMC:PMC9036165 | DOI:10.1155/2022/4584965

In Vivo. 2022 May-Jun;36(3):1391-1396. doi: 10.21873/invivo.12843.

ABSTRACT

BACKGROUND/AIM: There is limited evidence about the nephrotoxicity of calcium channel blockers (CCBs) and renin-angiotensin system (RAS) inhibitors with concomitant cisplatin (CDDP). We investigated whether combinations of antihypertensive drugs are associated with CDDP-related acute kidney injury (AKI) using the Japanese Adverse Drug Event Report database.

PATIENTS AND METHODS: We analysed 544,864 reports in the database from 2004 to 2020. A reporting odds ratio (ROR) and confidence interval (CI) with adjustment for potential confounding factors was calculated for AKI for each drug and the combined use of the drugs and CDDP.

RESULTS: CDDP, CCBs, and RAS inhibitors were all detected signals for AKI. The ROR in cases with concomitant use of CCBs, RAS inhibitors, and CDDP (adjusted ROR 7.28; 95% CI=5.56-9.54) was higher than that in cases with use of each drug.

CONCLUSION: AKI may require more attention when patients receiving CDDP take CCBs and RAS inhibitors together.

PMID:35478142 | DOI:10.21873/invivo.12843

CNS Spectr. 2022 Apr;27(2):236-237. doi: 10.1017/S1092852922000372.

ABSTRACT

INTRODUCTION: Adverse drug reactions (ADRs) are associated with increased morbidity, mortality, and resource utilization. Drug interactions (DDIs) are among the most common causes of ADRs, and estimates have cited that up to 22% of patients take interacting medications. DDIs are often due to the propensity for agents to induce or inhibit enzymes responsible for the metabolism of concomitantly administered drugs. However, this phenomenon is further complicated by genetic variants of such enzymes. The aim of this study is to quantify and describe potential drug-drug, drug-gene, and drug-drug-gene interactions in a community-based patient population.

METHODS: A regional pharmacy with retail outlets in Arkansas provided deidentified prescription data from March 2020 for 4761 individuals. Drug-drug and drug-drug-gene interactions were assessed utilizing the logic incorporated into GenMedPro, a commercially available digital gene-drug interaction software program that incorporates variants of 9 pharmacokinetic (PK) and 2 pharmacodynamic (PD) genes to evaluate DDIs and drug-gene interactions. The data were first assessed for composite drug-drug interaction risk, and each individual was stratified to a risk category using the logic incorporated in GenMedPro. To calculate the frequency of potential drug-gene interactions, genotypes were imputed and allocated to the cohort according to each gene's frequency in the general population. Potential genotypes were randomly allocated to the population 100 times in a Monte Carlo simulation. Potential drug-drug, gene-drug, or gene-drug-drug interaction risk was characterized as minor, moderate, or major.

RESULTS: Based on prescription data only, the probability of a DDI of any impact (mild, moderate, or major) was 26% [95% CI: 0.248-0.272] in the population. This probability increased to 49.6% [95% CI: 0.484-0.507] when simulated genetic polymorphisms were additionally assessed. When assessing only major impact interactions, there was a 7.8% [95% CI: 0.070-0.085] probability of drug-drug interactions and 10.1% [95% CI: 0.095-0.108] probability with the addition of genetic contributions. The probability of drug-drug-gene interactions of any impact was correlated with the number of prescribed medications, with an approximate probability of 77%, 85%, and 94% in patients prescribed 5, 6, or 7+ medications, respectively. When stratified by specific drug class, antidepressants (19.5%), antiemetics (21.4%), analgesics (16%), antipsychotics (15.6%), and antiparasitics (49.7%) had the highest probability of major drug-drug-gene interaction.

CONCLUSIONS: In a community-based population of outpatients, the probability of drug-drug interaction risk increases when genetic polymorphisms are attributed to the population. These data suggest that pharmacogenetic testing may be useful in predicting drug interactions, drug-gene interactions, and severity of interactions when proactively evaluating patient medication profiles.

FUNDING: Genomind, Inc.

PMID:35477626 | DOI:10.1017/S1092852922000372

Explor Res Clin Soc Pharm. 2021 Sep 3;3:100067. doi: 10.1016/j.rcsop.2021.100067. eCollection 2021 Sep.

ABSTRACT

BACKGROUND: Chronic health conditions and polypharmacy are common among the older population and associated with increased risks of adverse events, medicine-interactions, geriatric syndromes, falls and mortality. Poor nutrition is also common in older people. Causal associations between medication use and older people's nutrient status is seldom discussed.

OBJECTIVES: The objectives of this review were to summarise the literature reporting associations between medicines commonly prescribed to older adults and nutrient deficiencies, and to discuss the clinical implications and management.

METHODS: Medicine information resources (n = 5) were searched for information about nutrient deficiencies associated with common medicines used by older people and listed within the top 50 medicines prescribed by volume on the Australian Pharmaceutical Benefits Scheme. This was followed by a search for clinical studies published on PubMed from inception to April 2020. Data was extracted, tabulated and summarised with clinical information relevant to pharmacists and clinicians involved in the care of older people taking medicines.

RESULTS: A total of 23 clinical studies were identified reporting medicine-induced nutrient deficiencies in older adults. Vitamin B12, sodium, magnesium were identified as the 3 main nutrients susceptible to deficiency by medicines used to treat cardiovascular disease, neurological conditions, gastrointestinal conditions, and diabetes. The coenzyme CoQ10 was depleted by statins.Conclusion: Certain medicines commonly prescribed to older adults are associated with nutrient deficiencies that may be clinically significant. Given the high prevalence of comorbidities and polypharmacy it is possible that some of these individual drug-induced nutrient deficiencies are compounded, warranting both clinical and research attention.

PMID:35480616 | PMC:PMC9031754 | DOI:10.1016/j.rcsop.2021.100067

Front Pharmacol. 2022 Apr 5;13:854277. doi: 10.3389/fphar.2022.854277. eCollection 2022.

ABSTRACT

Background: Osimertinib is recommended either as the first-line therapy for sensitizing EGFR-mutations (FLAURA trial) or at progression to first-/second-generation EGFR inhibitors in the presence of resistance mutation T790M (AURA 3 study). It can effectively improve the prognosis of patients with NSCLC with manageable adverse reactions. Among adverse events, intestinal haemorrhage is rare and requires extensive study on its potential lethality. Case presentation: A 59-year-old female, diagnosed with relapsed stage IV (cT4N2M1c) NSCLC with T790M mutation of the EGFR gene, received osimertinib treatment. Eight months after osimertinib treatment, she complained of lower abdominal pain and haematochezia without haemorrhoids. Potential causes of intestinal haemorrhage other than osimertinib toxicity were ruled out. Colonoscopy examination showed severe colitis with grade 3 CTCAE. Osimertinib was discontinued, and prednisone 0.5 mg/kg was administered. Follow-up endoscopy showed no pathological findings. A novel third-generation EGFR-TKI, aumolertinib, was administrated. Five months after aumolertinib initiation, CT evaluation showed stable disease (SD), and this patient was free of colitis recurrence. Conclusion: To our knowledge, this is the first case report of severe colitis as an adverse event associated with osimertinib. Although osimertinib is the standard treatment for NSCLC in patients with T790M mutation and has fewer side effects, colitis may occur after months of treatment. Aumolertinib, a novel third-generation EGFR-TKI, might be an effective alternative for the treatment of patients with NSCLC experiencing colitis from osimertinib.

PMID:35479327 | PMC:PMC9037232 | DOI:10.3389/fphar.2022.854277

Eur J Hosp Pharm. 2022 Apr 27:ejhpharm-2022-003258. doi: 10.1136/ejhpharm-2022-003258. Online ahead of print.

ABSTRACT

OBJECTIVES: Linezolid is the first oxazolidinone antimicrobial agent developed for treating multi-drug-resistant gram-positive bacterial infections. The study aimed to investigate the risk factors of linezolid (LI)-induced thrombocytopenia (LI-TP) and to develop and validate a risk prediction model to identify elderly patients at high risk of developing LI-TP during linezolid therapy.

METHODS: A retrospective cohort study was performed at Zhongshan Hospital, FuDan University, China. The study involved elderly Chinese patients aged ≥65 years administered with linezolid (600 mg) twice a day between January 2015 and April 2021. We collected the patients' clinical characteristics and demographic data from electronic medical records, and compared the differences between LI-TP patients and those who had not developed thrombocytopenia (NO-TP) after linezolid treatment. The risk prediction model was developed based on the regression coefficient generated from logistic regression model.

RESULTS: A total of 343 inpatients were enrolled from January 2015 to August 2020 and were used as the training set. Among them, 67 (19.5%) developed LI-TP. Multivariate logistic regression analysis revealed that baseline platelet counts <150×109·L-1 (odds ratio (OR)=3.576; p<0.001), age ≥75 years (OR=2.258; p=0.009), estimated glomerular filtration rate (eGFR <60 mL·(min·1.73 m2)-1 (OR=2.553; p=0.002), duration of linezolid therapy ≥10 d (OR=3.218; p<0.001), intensive care unit (ICU) admittance (OR=2.682; p=0.004), concomitant piperacillin-tazobactam (OR=3.863; p=0.006) were independent risk factors for LI-TP in elderly patients. The LI-TP risk prediction model was established using a scoring method based on the regression coefficient and exhibited a good discriminative power, with an area under the curve (AUC) of 0.795 (95% confidence interval (CI) 0.740 to 0.851) and 0.849 (95% CI 0.760 to 0.939) in the training set (n=343) and validation set (n=90) respectively.

CONCLUSIONS: These findings indicate that duration of linezolid therapy, age, eGFR, ICU admittance, baseline platelet counts, concomitant piperacillin-tazobactam were significantly associated with LI-TP in elderly patients. A risk prediction model based on these risk factors showed a good discriminative performance and may be useful for clinicians to identify patients at high risk of developing LI-TP.

PMID:35477677 | DOI:10.1136/ejhpharm-2022-003258

AORN J. 2022 May;115(5):498-499. doi: 10.1002/aorn.13664.

NO ABSTRACT

PMID:35476198 | DOI:10.1002/aorn.13664

Sci Rep. 2022 Apr 26;12(1):6777. doi: 10.1038/s41598-022-10887-5.

ABSTRACT

A large number of adverse drug reaction (ADR) reports are collected yearly through the spontaneous report system (SRS). However, experienced experts from ADR monitoring centers (ADR experts, hereafter) reviewed only a few reports based on current policies. Moreover, the causality assessment of ADR reports was conducted according to the official approach based on the WHO-UMC system, a knowledge- and labor-intensive task that highly relies on an individual's expertise. Our objective is to devise a method to automatically assess ADR reports and support the efficient exploration of ADRs interactively. Our method could improve the capability to assess and explore a large volume of ADR reports and aid reporters in self-improvement. We proposed a workflow for assisting the assessment of ADR reports by combining an automatic assessment prediction model and a human-centered interactive visualization method. Our automatic causality assessment model (ACA model)-an ordinal logistic regression model-automatically assesses ADR reports under the current causality category. Based on the results of the ACA model, we designed a warning signal to indicate the degree of the anomaly of ADR reports. An interactive visualization technique was used for exploring and examining reports extended by automatic assessment of the ACA model and the warning signal. We applied our method to the SRS report dataset of the year 2019, collected in Guangdong province, China. Our method is evaluated by comparing automatic assessments by the ACA model to ADR reports labeled by ADR experts, i.e., the ground truth results from the multinomial logistic regression and the decision tree. The ACA model achieves an accuracy of 85.99%, a multiclass macro-averaged area under the curve (AUC) of 0.9572, while the multinomial logistics regression and decision tree yield 80.82%, 0.8603, and 85.39%, 0.9440, respectively, on the testing set. The new warning signal is able to assist ADR experts to quickly focus on reports of interest with our interactive visualzation tool. Reports of interest that are selected with high scores of the warning signal are analyzed in details by an ADR expert. The usefulness of the overall method is further evaluated through the interactive analysis of the data by ADR expert. Our ACA model achieves good performance and is superior to the multinomial logistics and the decision tree. The warning signal we designed allows efficient filtering of the full ADR reports down to much fewer reports showing anomalies. The usefulness of our interactive visualization is demonstrated by examples of unusual reports that are quickly identified. Our overall method could potentially improve the capability of analyzing ADR reports and reduce human labor and the chance of missing critical reports.

PMID:35474237 | DOI:10.1038/s41598-022-10887-5

Scand J Immunol. 2022 Apr 27:e13174. doi: 10.1111/sji.13174. Online ahead of print.

ABSTRACT

Gut microbiota (GM) play important roles in multiple organ function, homeostasis and several diseases. More recently, increasing evidences have suggested that the compositional and functional alterations of GM play a crucial role in the accumulation of foam cells and the formation of atherosclerotic plaque in atherosclerosis. In particular, the effects of bacterial components and metabolites on innate and adaptive immune cells have been explored as the underlying mechanisms. Understanding the effects of GM and metabolites on immunoregulation are important for clinical therapy for atherosclerosis. Herein, we summarize the potential role of the GM (such as bacterial components lipopolysaccharide and peptidoglycan) and GM-derived metabolites (such as short-chain fatty acids, trimethylamine N-oxide and bile acids) in the immunopathology of atherosclerosis. Based on that, we further discuss the anti-atherosclerotic effects of GM-directed dietary bioactive factors such as dietary fibers, dietary polyphenols and probiotics. Because of drug-induced adverse events in anti-inflammatory therapies, personalized dietary interventions would be potential therapies for atherosclerosis, and the interactions between GM-derived products and immune cells should be studied further.

PMID:35474231 | DOI:10.1111/sji.13174

Drug Ther Bull. 2022 May;60(5):66-67. doi: 10.1136/dtb.2022.000007.

NO ABSTRACT

PMID:35473818 | DOI:10.1136/dtb.2022.000007

Drug Ther Bull. 2022 May;60(5):70. doi: 10.1136/dtb.2022.000021.

ABSTRACT

Overview of: Vitarello JA, Fitzgerald CJ, Cluett JL, et al Prevalence of medications that may raise blood pressure among adults with hypertension in the United States. JAMA Intern Med 2022;182:90-3.

PMID:35473817 | DOI:10.1136/dtb.2022.000021

J Korean Med Sci. 2022 Apr 25;37(16):e128. doi: 10.3346/jkms.2022.37.e128.

ABSTRACT

BACKGROUND: Adverse drug reactions (ADRs) to first-line anti-tuberculosis (TB) drugs are common; however, there have been few reports of nationwide epidemiologic studies on ADRs to anti-TB drugs in Korea. This study aimed to investigate the clinical characteristics of various ADRs to first-line anti-TB drugs using a nationwide database of ADRs.

METHODS: We used the Korea Adverse Event Reporting System (KAERS) database (2009-2018). The study subjects were selected using the Korean Standard Classification of Diseases codes for pulmonary and extrapulmonary TB and electronic data interchange codes for isoniazid (INH), rifampicin (RIF), ethambutol (ETB), and pyrazinamide (PZA). The causality assessment of "possible," "probable," or "certain" by World Health Organization-Uppsala Monitoring Center System causality category was selected.

RESULTS: A total of 1,562,024 ADRs were reported in the KIDS-KAERS database from 2009 to 2018, where ADRs to first-line anti-TB drugs were 17,843 cases (1.14%). The most common causative drugs were RIF (28.7%), INH (24.0%), ETB (23.4%), and PZA (23.9%) in that order. 48.5% of cases were reported in the older patients (≥ 60 years). According to organ system, gastro-intestinal system disorder was most common (32.0%), followed by skin and appendage (25.9%), liver and biliary system (14.2%). Nausea was the most common ADR (14.6%), followed by hepatic enzyme elevation (14.2%), rash (11.7%), pruritus (9.1%), vomiting (8.9%), and urticaria (4.2%). Most ADRs appeared within 1 month, but ADRs such as neuropathy, paresthesia, hematologic abnormalities, renal function abnormalities and liver enzyme abnormality were also often reported after 2 months.

CONCLUSION: Our data are clinically informative for recognizing and coping with ADRs of anti-TB drugs.

PMID:35470602 | DOI:10.3346/jkms.2022.37.e128

BMJ. 2022 Apr 25;377:o1051. doi: 10.1136/bmj.o1051.

NO ABSTRACT

PMID:35470157 | DOI:10.1136/bmj.o1051