| アブストラクト | BACKGROUND: Donepezil in combination with memantine is a widely used clinical therapy for moderate to severe dementia. However, real-world population data on the long-term safety of donepezil in combination with memantine are incomplete and variable. Therefore, the aim of this study was to analyze the adverse events (AEs) of donepezil in combination with memantine according to US Food and Drug Administration Adverse Event Reporting System (FAERS) data to provide evidence for the safety monitoring of this therapy. METHODS: We retrospectively analyzed reports of AEs associated with the combination of donepezil and memantine from 2004 to 2023 extracted from the FAERS database. Whether there was a significant association between donepezil and memantine combination therapy and AEs was assessed using four disproportionality analysis methods, namely, the reporting odds ratio, proportional reporting ratio, Bayesian confidence propagation neural network, and multi-item gamma Poisson shrinker methods. To further investigate potential safety issues, we also analyzed differences and similarities in the time of onset and incidence of AEs stratified by sex and differences and similarities in the incidence of AEs stratified by age. RESULTS: Of the 2,400 adverse drug reaction (ADR) reports in which the combination of donepezil and memantine was the primary suspected drug, most of the affected patients were female (54.96%) and older than 65 years of age (79.08%). We identified 22 different system organ classes covering 100 AEs, including some common AEs such as dizziness and electrocardiogram PR prolongation; fall, pleurothotonus and myoclonus were AEs that were not listed on the drug label. Moreover, we obtained 88 reports of AEs in men and 100 reports of AEs in women; somnolence was a common AE in both men and women and was more common in women, whereas pleurothotonus was a more common AE in men. In addition, we analyzed 12 AEs in patients younger than 18 years, 16 in patients between 18 and 65 years, and 113 in patients older than 65 years. The three age groups had distinctive AEs, but lethargy was the common AE among all age groups. Finally, the median time to AE onset was 19 days in all cases. In both men and women, most AEs occurred within a month of starting donepezil plus memantine, but some continued after a year of treatment. CONCLUSION: Our study identified potential and new AEs of donepezil in combination with memantine; some of these AEs were the same as in the specification, and some of the AE signals were not shown in the specification. In addition, there were sex and age differences in some of the AEs. Therefore, our findings may provide valuable insights for further studies on the safety of donepezil and memantine combination therapy, which are expected to contribute to the safe use of this therapy in clinical practice. |
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| ジャーナル名 | Frontiers in pharmacology |
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| 投稿日 | 2024/8/5 |
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| 投稿者 | Yang, Yihan; Wei, Sheng; Tian, Huan; Cheng, Jing; Zhong, Yue; Zhong, Xiaoling; Huang, Dunbing; Jiang, Cai; Ke, Xiaohua |
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| 組織名 | The Institution of Rehabilitation Industry, Fujian University of Traditional;Chinese Medicine, Fuzhou, China.;Department of General Practice, The Second Affiliated Hospital of Wannan Medical;College, Anhui, China.;Department of Rehabilitation Medicine, Shanghai Fourth People's Hospital, School;of Medicine, Tongji University, Shanghai, China.;School of Health and Rehabilitation, Chengdu University of Traditional Chinese;Medicine, Chengdu, China.;The First Clinical Medical College, Fujian University of Traditional Chinese;Medicine, Fuzhou, China.;Guangdong Provincial Hospital of Chinese Medicine, The Second Clinical School of;Guangzhou University of Chinese Medicine, Guangzhou, China.;Rehabilitation Medicine Center, Fujian Provincial Hospital, Fuzhou, China.;Shengli Clinical Medical College of Fujian Medical University, Fuzhou, China.;Fuzhou University Affiliated Provincial Hospital, Fuzhou, China. |
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| Pubmed リンク | https://www.ncbi.nlm.nih.gov/pubmed/39101151/ |
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