Characterization of auto-immune hepatitis associated with the use of anti-TNFalpha agents: An analysis of 389 cases in VigiBase.
|アブストラクト||Auto-immune diseases, including auto-immune hepatitis may be associated with the use of drugs, such as anti-TNF-alpha inhibitors. The aim of the study was to analyze the characteristics of anti-TNF-alpha inhibitor-associated auto-immune hepatitis (ATIAIH) in a large international pharmacovigilance database. We analyzed all ICSRs classified as "Autoimmune hepatitis" according to the Medical Dictionary for Drug Regulatory Activities term (preferred term level) in VigiBase, the World Health Organization global pharmacovigilance database of adverse drug reactions collected by national drug authorities in >130 countries (>90% of the world population). Bayesian disproportionality analysis was used to compute IC025, which is the lower end of the 95% credibility interval for the association between a suspected treatment and an adverse event. IC025 > 0 are considered statistically significant. A total of 389 ATIAIH ICSRs were identified. The median age at ATIAIH onset was 44 years and the female to male sex ratio was 3.72. Infliximab (IC025 = 2.98), adalimumab (IC025 = 0.32) and etanercept (IC025 = 0.19) yielded a statistically significant signal in disproportionality analysis. Infliximab was the most frequently involved drug (50.1%). The median treatment duration before ATIAH occurrence was 4.9 months. ATIAIH was reported as serious adverse event in 91%. Death (directly linked to AIH or not) occurred in 10 cases (2.9% of ICSRs). The most frequent reported indication for anti-TNF-alpha agent was rheumatoid arthritis (31.9%). This study enables the identification and a detailed study of 389 new cases of ATIAIH and confirms a significant association of ATIAIH with infliximab, adalimumab and etanercept.|
|投稿者||Vollmer, Olivier; Felten, Renaud; Mertz, Philippe; Lebrun-Vignes, Benedicte; Salem, Joe-Elie; Arnaud, Laurent|
|組織名||Service de Rhumatologie, Hopitaux Universitaires de Strasbourg, Centre National;de References des Maladies Systemiques et Autoimmunes Rares Est Sud-Ouest (RESO),;Universite de Strasbourg, F-67000 Strasbourg, France.;AP-HP, Pitie-Salpetriere Hospital, Department of Pharmacology, CIC-1421, Regional;Pharmacovigilance Center, INSERM, Sorbonne Universites, F-75013 Paris, France; EA;7379 EpidermE, Universite Paris-Est Creteil, UPEC, Creteil F-94010, France.;Pharmacovigilance Center, INSERM, Sorbonne Universites, F-75013 Paris, France.;Universite de Strasbourg, F-67000 Strasbourg, France.. Electronic address:;Laurent.email@example.com.|