Analysis of gemcitabine adverse drug reactions and risk factors in Inner Mongolia
- VernacularTitle:内蒙古地区吉西他滨的药物不良反应及危险因素分析
- Author:
Shengnan YANG
1
,
2
;
Wei SHI
3
;
Yufang ZHAO
1
,
2
;
Zhien LIU
1
,
2
;
Wenpu LEI
1
,
2
;
Yanan ZHANG
1
,
2
;
Ke ZHAO
1
,
2
;
Hao GUO
1
Author Information
1. Dept. of Pharmacy,Inner Mongolia People’s Hospital,Hohhot 010017,China
2. Inner Mongolia Comprehensive Evaluation Center for Essential Drugs and Clinical Evaluation,Hohhot 010017,China
3. Pharmacovigilance Center of Inner Mongolia,Hohhot 010041,China
- Publication Type:Journal Article
- Keywords:
gemcitabine;
adverse drug reactions;
risk factors;
rational drug use
- From:
China Pharmacy
2025;36(4):486-490
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVE To analyze the occurrence characteristics and risk factors of adverse drug reactions (ADR) of gemcitabine for injection in national centralized volume-based procurement (hereinafter referred to as “centralized procurement”), and provide reference for clinical safe drug use. METHODS A retrospective study was conducted to collect the relevant case reports of gemcitabine for injection reported to the National Adverse Drug Reaction Monitoring System by Inner Mongolia Autonomous Region from January 2022 to December 2023; basic information of patients, drug use status, patient outcomes, rational drug use and other information were collected, and the occurrence characteristics of ADRs with leukopenia, myelosuppression, neutropenia, thrombocytopenia and liver dysfunction were analyzed. Univariate analysis and multivariate Logistic regression were used to analyze the correlation of gender, age, combination of antitumor drugs, original malignant tumor and drug dose with ADR. RESULTS A total of 315 cases reports (315 patients) of gemcitabine-induced ADR were included in this study, with a male-to-female ratio of 1.42∶1 and age of (61.17±9.13) years. The primary malignant tumor was pancreatic cancer (73 cases, 23.17%). Leukopenia, myelosuppression and nausea were the most common ADR, followed by neutropenia, thrombocytopenia, liver dysfunction and so on. The severity grade of ADR was mainly 1-2, and the outcome of most ADR was good. Multivariate Logistic regression analysis showed that combination of antitumor drugs was a risk factor for myelosuppression and neutropenia (RR=2.154, 95%CI: 1.218- 3.807, P=0.008; RR=3.099, 95%CI: 1.240-7.744, P=0.016); gender (female) was a risk factor for leukopenia and liver dysfunction (RR=0.508, 95%CI: 0.302-0.853, P=0.010; RR=0.301, 95%CI: 0.102-0.887, P=0.029). In terms of drug use rationality, there were 143 cases (45.40%) of drug 126.com use in accordance with the indications of the label, and 172 cases (54.60%) of off-label drug use. Among them, the primary malignant tumors were bladder cancer, bile duct cancer and ovarian cancer, which ranked the top three off-label drug use. CONCLUSIONS The ADR caused by gemcitabine in Inner Mongolia is mainly in the blood and digestive systems. The severity of ADRs is mainly classified as 1-2 levels, and most ADRs have good outcomes. Gender (female) and combination medication are risk factors for gemcitabine-induced ADR. Appropriate chemotherapy regimen should be selected according to the patient’s condition and physical condition, and ADR monitoring in blood and digestive systems should be strengthened during medication of gemcitabine.