| アブストラクト | PURPOSE: While use of carbonic anhydrase inhibitors (CAI) rises, studies of urinary stone formation with CAIs are limited. We sought to study the association between CAIs and reports of stone-related adverse drug reactions (ADR), investigate dose-dependent associations, and identify at-risk clinical subgroups. METHODS AND MATERIALS: We conducted a pharmacovigilance case-noncase study of signals of stone formation reported with CAIs in VigiBase, a WHO global database of case-safety reports. We included all adverse events (1967 to 2022); only duplicate reports identified by VigiBase were excluded. We conducted disproportionality analysis with a significance threshold of the lower bound 95% Empiric Bayes Estimator >1 and described the reporting odds ratio (ROR) and 95% CI. RESULTS: Of 63,448,915 adverse events, we identified 246 reports of stone-related ADRs with CAI use. CAIs were significantly associated with stone-related ADRs (ROR 5.02; 95% CI 4.43-5.70). Significant disproportionality signals were observed for topiramate (ROR 4.91; 95% CI 4.27-5.65), zonisamide (ROR 8.00; 95% CI 5.84-10.96), and acetazolamide (ROR 2.56; 95% CI 1.42-4.62). Stone-related ADRs were heavily reported in patients aged <45 (ROR 8.72; 95% CI 7.06-10.76) and patients taking zonisamide and topiramate for seizure (ROR 9.40; 95% CI 6.87-12.85). Dose-dependent associations were observed with topiramate (ROR 25-99mg: 3.20; ROR 100-199mg: 5.92; ROR 200-400mg: 6.57) and zonisamide (ROR 100-199mg: 6.79; ROR 200-399mg: NS, ROR 400-600mg: 14.29). CONCLUSIONS: CAIs were significantly associated with dose-dependent reporting of stone-related ADRs. Younger patients and patients with indication of seizure had higher risk of reporting stone-related ADRs. At-risk patients should be counseled on the risk of developing stones when taking CAIs. |
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| ジャーナル名 | Urology practice |
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| Pubmed追加日 | 2025/11/21 |
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| 投稿者 | Song, Jonathan J; Jones, James McAndrew 3rd; Wang, David S; Conti, Simon; Pao, Alan C; Wollin, Daniel A |
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| 組織名 | Boston University Chobanian and Avedisian School of Medicine, Boston, MA.;Department of Urology, Boston Medical Center, Boston, MA.;Department of Urology, Stanford University School of Medicine, Palo Alto, CA.;Department of Nephrology, Stanford University School of Medicine, Palo Alto, CA.;Department of Urology, Brigham and Women's Hospital, Boston, MA. |
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| Pubmed リンク | https://www.ncbi.nlm.nih.gov/pubmed/41269869/ |
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