Background:To investigate adverse event(AE)signals associated with six proton pump inhibitors(PPIs),enhance drug labeling information,and provide guidance for their safe clinical use.Methods:Adverse reaction data for ...Background:To investigate adverse event(AE)signals associated with six proton pump inhibitors(PPIs),enhance drug labeling information,and provide guidance for their safe clinical use.Methods:Adverse reaction data for musculoskeletal and connective tissue disorders related to six PPI formulations—omeprazole,pantoprazole,lansoprazole,esomeprazole,rabeprazole,and dexlansoprazole—from Q12004 to Q42023 were collected from the FDA Adverse Event Reporting System(FAERS).Signal detection was performed using the Reporting Odds Ratio(ROR),Proportional Reporting Ratio(PRR),Bayesian Confidence Propagation Neural Network(BCPNN),and Empirical Bayesian Geometric Mean(EBGM).Data processing and statistical analysis were conducted using R Studio 4.40.Results:A total of 6,635,3,853,1,792,15,731,483,and 534 adverse events were identified for the six PPIs,respectively.The four algorithms(ROR,PRR,BCPNN,and EBGM)generated 17,19,8,27,5,and 2 positive signals.Notably,signals for renal osteodystrophy and osteoporosis were more frequent,with stronger signals for lumbar flexion syndrome and renal osteodystrophy.Conclusion:Patients with chronic kidney disease,a high risk of osteoporosis and fractures,or those using statins should select PPIs with a lower risk of adverse musculoskeletal and connective tissue reactions to minimize these adverse effects and ensure standardized clinical use of PPIs.展开更多
The Loeys-Dietz syndrome (LDS) is a connective tissue disorder that is associated with vascular abnormalities, including aggressive aortic aneurysms, as well as skeletal and craniofacial malformations. The molecular m...The Loeys-Dietz syndrome (LDS) is a connective tissue disorder that is associated with vascular abnormalities, including aggressive aortic aneurysms, as well as skeletal and craniofacial malformations. The molecular mechanism of this syndrome remains to be fully elucidated. In this case, we describe a 29-year-old woman, gravida 2 para 1, who was referred for consultation after urinary tract malformations were observed during her mid-gestation anatomic survey. Following referral to our unit, ultrasound examination of the 21-week fetus was repeated. The fetus was observed to have a dilated aortic root and a poorly ossified sternum with mild pectus deformity. After elective termination, single nucleotide polymorphism microarray testing identified a novel 204 kb microdeletion involving the short arm of chromosome 3. The deleted genetic material included 4 exons of the TGFBR2 gene. Although the phenotype of LDS may be caused by haploinsufficiency of the TGFBR1 or TGFBR2 gene, our experience suggests a more complex picture of LDS. The study of such cases might further elucidate its pathogenesis.展开更多
文摘Background:To investigate adverse event(AE)signals associated with six proton pump inhibitors(PPIs),enhance drug labeling information,and provide guidance for their safe clinical use.Methods:Adverse reaction data for musculoskeletal and connective tissue disorders related to six PPI formulations—omeprazole,pantoprazole,lansoprazole,esomeprazole,rabeprazole,and dexlansoprazole—from Q12004 to Q42023 were collected from the FDA Adverse Event Reporting System(FAERS).Signal detection was performed using the Reporting Odds Ratio(ROR),Proportional Reporting Ratio(PRR),Bayesian Confidence Propagation Neural Network(BCPNN),and Empirical Bayesian Geometric Mean(EBGM).Data processing and statistical analysis were conducted using R Studio 4.40.Results:A total of 6,635,3,853,1,792,15,731,483,and 534 adverse events were identified for the six PPIs,respectively.The four algorithms(ROR,PRR,BCPNN,and EBGM)generated 17,19,8,27,5,and 2 positive signals.Notably,signals for renal osteodystrophy and osteoporosis were more frequent,with stronger signals for lumbar flexion syndrome and renal osteodystrophy.Conclusion:Patients with chronic kidney disease,a high risk of osteoporosis and fractures,or those using statins should select PPIs with a lower risk of adverse musculoskeletal and connective tissue reactions to minimize these adverse effects and ensure standardized clinical use of PPIs.
文摘The Loeys-Dietz syndrome (LDS) is a connective tissue disorder that is associated with vascular abnormalities, including aggressive aortic aneurysms, as well as skeletal and craniofacial malformations. The molecular mechanism of this syndrome remains to be fully elucidated. In this case, we describe a 29-year-old woman, gravida 2 para 1, who was referred for consultation after urinary tract malformations were observed during her mid-gestation anatomic survey. Following referral to our unit, ultrasound examination of the 21-week fetus was repeated. The fetus was observed to have a dilated aortic root and a poorly ossified sternum with mild pectus deformity. After elective termination, single nucleotide polymorphism microarray testing identified a novel 204 kb microdeletion involving the short arm of chromosome 3. The deleted genetic material included 4 exons of the TGFBR2 gene. Although the phenotype of LDS may be caused by haploinsufficiency of the TGFBR1 or TGFBR2 gene, our experience suggests a more complex picture of LDS. The study of such cases might further elucidate its pathogenesis.
