摘要
目的系统评估六种常用沙坦类药物(缬沙坦、厄贝沙坦、坎地沙坦、氯沙坦、奥美沙坦、替米沙坦)诱发粒细胞缺乏症的风险差异。方法基于2004年~2024年FDA不良事件报告系统(FAERS)数据,采用报告比值比、信息组分等四类算法进行信号挖掘,并用log10(卡方值)散点图可视化风险强度。结果共发现粒细胞缺乏症14916例,其中142例首因疑为沙坦类。厄贝沙坦风险最高(ROR=5.63),坎地沙坦(ROR=2.02)与缬沙坦(ROR=1.46)为中低度信号,奥美沙坦、替米沙坦、氯沙坦无显著风险。65岁以上患者占比更高(56.34%vs 31.68%,P<0.001),住院率亦升高(P=0.018)。结论不同沙坦类药物的粒细胞缺乏风险存在显著差异,老年人用药需加强监测。
OBJECTIVE To systematically evaluate the differential risk of agranulocytosis associated with six commonly used angiotensinⅡreceptor blockers(ARBs):valsartan,irbesartan,candesartan,losartan,olmesartan,and telmisartan.METHODS A pharmacovigilance analysis was conducted using data from the FDA Adverse Event Reporting System(FAERS)from 2004 to 2024.Four signal detection algorithms,including Reporting Odds Ratio(ROR)and Information Component(IC),were applied.Risk signal strength was visualized using log10(chi-square)scatter plots with significance thresholds.RESULTS A total of 14,916 reports of agranulocytosis were identified,among which 142 cases were primarily attributed to ARB use.Irbesartan exhibited the strongest signal(ROR=5.63,95% CI:4.04-7.84),while candesartan(ROR=2.02)and valsartan(ROR=1.46)showed weak to moderate signals.No significant association was found for olmesartan,telmisartan,or losartan.Patients aged 65 and older accounted for a significantly higher proportion of cases(56.34%vs.31.68%,P<0.001)and experienced a higher hospitalization rate(68.31% vs.58.52%,P=0.018).CONCLUSION The risk of agranulocytosis varies notably among ARBs.Irbesartan appears to carry the highest risk,while olmesartan may offer a safer profile.Special attention and monitoring are recommended for elderly patients using ARBs.
作者
饶志辉
RAO Zhi-Hui(Department of Pharmacy,Longyan First Affiliated Hospital of Fujian Medical University,Longyan 364000,China)
出处
《海峡药学》
2025年第12期133-138,共6页
Strait Pharmaceutical Journal
