Safety Profile of Sclerosing Agents: An Analysis From the World Health Organization Pharmacovigilance Database VigiBase.


Journal

Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.]
ISSN: 1524-4725
Titre abrégé: Dermatol Surg
Pays: United States
ID NLM: 9504371

Informations de publication

Date de publication:
12 2019
Historique:
pubmed: 5 3 2019
medline: 26 2 2020
entrez: 5 3 2019
Statut: ppublish

Résumé

Several sclerosing agents are used to treat chronic venous diseases. Although they do not seem to differ in terms of efficacy, their safety profiles might differ. To compare the safety profile of sclerosing agents through an analysis of the World Health Organization pharmacovigilance database. The authors performed a disproportionality analysis using the proportional reporting ratio (PRR) method to compare pharmacovigilance signals between each sclerosing agent among 6 adverse event syndromes of interest: hypersensitivity reactions, arterial thromboembolic disorders, venous thromboembolic disorders, cardiac arrhythmias, visual/neurological disturbances, and skin ulcerations. The cutoff for signal detection was defined by a logPRR lower boundary 95% confidence interval (CI) ≥0 and number of cases n ≥3. Of 1,227 Individual Case Safety Reports (ICSRs) identified, after removal of ICSRs with unselected indications, the authors selected 472 reports for the analysis. The authors found that polidocanol is associated with more reporting of venous embolic/thrombotic events (logPRR = 1.38 [95% CI 1.27-1.49]), ethanolamine with the higher pharmacovigilance disproportionality signal of cardiac arrhythmias (logPRR = 0.80 [95% CI 0.51-1.09]), and STS with more reporting of allergic reactions (logPRR = 1.79 [95% CI 1.59-1.98]). The safety profile of sclerosing agents significantly differs and should guide benefit-risk ratio assessment of such agents.

Sections du résumé

BACKGROUND
Several sclerosing agents are used to treat chronic venous diseases. Although they do not seem to differ in terms of efficacy, their safety profiles might differ.
OBJECTIVE
To compare the safety profile of sclerosing agents through an analysis of the World Health Organization pharmacovigilance database.
METHODS
The authors performed a disproportionality analysis using the proportional reporting ratio (PRR) method to compare pharmacovigilance signals between each sclerosing agent among 6 adverse event syndromes of interest: hypersensitivity reactions, arterial thromboembolic disorders, venous thromboembolic disorders, cardiac arrhythmias, visual/neurological disturbances, and skin ulcerations. The cutoff for signal detection was defined by a logPRR lower boundary 95% confidence interval (CI) ≥0 and number of cases n ≥3.
RESULTS
Of 1,227 Individual Case Safety Reports (ICSRs) identified, after removal of ICSRs with unselected indications, the authors selected 472 reports for the analysis. The authors found that polidocanol is associated with more reporting of venous embolic/thrombotic events (logPRR = 1.38 [95% CI 1.27-1.49]), ethanolamine with the higher pharmacovigilance disproportionality signal of cardiac arrhythmias (logPRR = 0.80 [95% CI 0.51-1.09]), and STS with more reporting of allergic reactions (logPRR = 1.79 [95% CI 1.59-1.98]).
CONCLUSION
The safety profile of sclerosing agents significantly differs and should guide benefit-risk ratio assessment of such agents.

Identifiants

pubmed: 30829775
doi: 10.1097/DSS.0000000000001876
doi:

Substances chimiques

Sclerosing Solutions 0
Polidocanol 0AWH8BFG9A
Ethanolamine 5KV86114PT
Sodium Tetradecyl Sulfate Q1SUG5KBD6

Types de publication

Comparative Study Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

1517-1528

Commentaires et corrections

Type : CommentIn

Auteurs

Audrey Roselli (A)

Pharmacovigilance Unit, Grenoble Alpes University Hospital, Grenoble, France.

Charles Khouri (C)

Pharmacovigilance Unit, Grenoble Alpes University Hospital, Grenoble, France.
Clinical Pharmacology Department INSERM CIC1406, Grenoble Alpes University Hospital, Grenoble, France.
UMR 1042-HP2, INSERM, University Grenoble Alpes, Grenoble, France.

Matthieu Roustit (M)

Clinical Pharmacology Department INSERM CIC1406, Grenoble Alpes University Hospital, Grenoble, France.
UMR 1042-HP2, INSERM, University Grenoble Alpes, Grenoble, France.

Sophie Blaise (S)

UMR 1042-HP2, INSERM, University Grenoble Alpes, Grenoble, France.
Department of Vascular Medicine, Grenoble Alpes University Hospital, Grenoble, France.

Jean-Luc Cracowski (JL)

Clinical Pharmacology Department INSERM CIC1406, Grenoble Alpes University Hospital, Grenoble, France.
UMR 1042-HP2, INSERM, University Grenoble Alpes, Grenoble, France.

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Classifications MeSH