| アブストラクト | BACKGROUND: No worldwide pharmacovigilance study evaluating the spectrum of adverse drug reactions (ADRs) induced by cholinesterase inhibitors (ChEI) in Alzheimer's disease has been conducted since their emergence on the market. OBJECTIVE: To describe ChEI related ADRs in Alzheimer's disease (donepezil, rivastigmine, and galantamine) and characterize their seriousness as reported by national pharmacovigilance systems to VigiBase, a World Health Organization International Drug Monitoring Program database, between 1998 and 2013. METHODS: All ChEI RELATED REPORTS: , submitted to VigiBase between 1998 and 2013 from THE FIVE CONTINENTS: were extracted. Analyses were carried out for general, serious, and nonserious ADRs. RESULTS: A total of 18 955 reports (43 753 ADRs) FROM 58 COUNTRIES: were reported: 60.1% in women; mean age 77.4 +/- 9.1 years. Most reports originated from Europe (47.6%) and North America (40.4%). Rivastigmine and donepezil were involved in MOST: reports (41.4% each). The most frequently reported ADRs were neuropsychiatric (31.4%), gastrointestinal (15.9%), general (11.9%), and cardiovascular (11.7%) disorders. During the 2006-2013 period, serious ADRs remained more often reported than nonserious ones; the most serious were neuropsychiatric (34.0%), general (14.0%), cardiovascular (12.1%), and gastrointestinal (11.6%) disorders. Medication errors were reported in 2.0% of serious cases. Death occurred in 2.3% of the reports. CONCLUSIONS: This international pharmacovigilance study highlights the ADR pattern induced by ChEIs. Neuropsychiatric events were the most frequently reported ADRs. Serious cardiovascular events were frequently reported, suggesting that their significance has probably been previously underestimated. Given the frailty of the patients and the frequent comedications, caution is advised before introducing a ChEI. |
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| ジャーナル名 | The Annals of pharmacotherapy |
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| Pubmed追加日 | 2015/9/2 |
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| 投稿者 | Kroger, Edeltraut; Mouls, Marie; Wilchesky, Machelle; Berkers, Mieke; Carmichael, Pierre-Hugues; van Marum, Rob; Souverein, Patrick; Egberts, Toine; Laroche, Marie-Laure |
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| 組織名 | Centre de Recherche du CHU de Quebec, Canada Universite Laval, Quebec, Canada.;Service de Pharmacologie-Toxicologie-Pharmacovigilance, Limoges, France.;McGill University, Montreal, Canada Centre for Clinical Epidemiology Jewish;General Hospital-Lady Davis Research Institute, Montreal, Canada Donald Berman;Maimonides Geriatric Centre, Montreal, Canada.;Utrecht University, Netherlands.;Centre de Recherche du CHU de Quebec, Canada.;Jeroen-Bosch Ziekenhuis, 's-Hertogenbosch, Netherlands EMGO Institute for Health;and Care Research VU University Medical Center Amsterdam, Netherlands.;Utrecht University, Netherlands University Medical Centre, Utrecht, Netherlands.;Service de Pharmacologie-Toxicologie-Pharmacovigilance, Limoges, France;Universite de Limoges, Limoges, France marie-laure.laroche@chu-limoges. |
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| Pubmed リンク | https://www.ncbi.nlm.nih.gov/pubmed/26324356/ |
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