1.Adverse Event Signals of Interstitial Lung Disease in the FDA Adverse Event Reporting System (FAERS) Database and the Japanese Adverse Drug Event Report (JADER) Database
Toshinobu Matsui ; Ryogo Umetsu ; Yamato Kato ; Natsumi Ueda ; Junko Abe ; Yoko Nakayama ; Yuuki Hane ; Yasutomi Kinosada ; Mitsuhiro Nakamura
Japanese Journal of Drug Informatics 2015;17(3):145-154
The Japanese Ministry of Health, Labor, and Welfare lists interstitial lung disease as an serious adverse drug event. The Food and Drug Administration Adverse Event Reporting System (FAERS) and the Japanese Adverse Drug Event Report (JADER) databases are available to detect adverse events signals. We analyzed reports of interstitial lung disease in FAERS and JADER and calculated the reporting fraction and reporting odds ratio (ROR) of drugs potentially associated with interstitial lung disease. We applied Weibull shape parameter to time-to-event data in JADER. We found FAERS to contain 3,522,995 reports from January 2004 to March 2013 and JADER to contain 292,720 reports from April 2004 to November 2013. In FAERS, the reporting fractions of interstitial lung disease for Gefitinib, Bleomycin, and Amiodarone were 7.4% (285/3,856 reports), 3.2% (86/2,663 reports), and 1.9% (357/18,366 reports), and RORs (95% confidence interval [CI]) were 29.26 (25.89-33.07), 11.99 (9.66-14.88), and 7.29 (6.55-8.11), respectively. In JADER, the reporting fractions of interstitial lung disease for Gefitinib, Bleomycin, and Amiodarone were 45.6% (1,070/2,348 reports), 22.1% (77/348 reports), and 27.9% (468/1,678 reports), and RORs (95% CI) were 18.46 (16.99-20.06), 5.83 (4.52-7.51), and 8.14 (7.31-9.07), respectively. Adverse event signals of interstitial lung disease were observed in most drugs, which are warned as a suspected drug in the literature. With the time-to-event analysis using Weibull shape parameter, time-dependency of adverse events in each drug was different. Therefore, these drugs should be used carefully in clinical practice.
2.Analysis of the Association between Neuraminidase Inhibitors and Neuropsychiatric Adverse Events Using Japanese Adverse Drug Event Report (JADER)
Natsumi Ueda ; Yamato Kato ; Junko Abe ; Yoko Nakayama ; Toshinobu Matsui ; Yuuki Hane ; Sayaka Sasaoka ; Yumi Motooka ; Haruna Hatahira ; Yasutomi Kinosada ; Zenichiro Kato ; Mitsuhiro Nakamura
Japanese Journal of Drug Informatics 2016;18(1):38-45
There have been concerns that neuraminidase inhibitors (oseltamivir, zanamivir, laninamivir, and peramivir) cause neuropsychiatric adverse events (NPAEs). We evaluated the number of relevant reports, reporting ratio, and reporting odds ratio (ROR) by using spontaneous reporting database, such as the Japanese Adverse Drug Event Report (JADER) (April 2004 to July 2014). The RORs of oseltamivir, zanamivir, laninamivir, and peramivir were 11.8 (95% confidence interval (CI), 10.8-13.0), 47.0 (95% CI, 40.0-55.3), 9.5 (95% CI, 6.8-13.2), and 3.3 (95% CI, 2.1-5.1), respectively. The lower limit of the ROR 95% CI of NPAEs of all neuraminidase inhibitors was ≥1. We analyzed the association of age and gender with NPAEs in patients treated with oseltamivir using a logistic regression model. The adjusted ROR of NPAEs was 66.9 (95% CI, 50.3-88.9) in male patients treated with osletamivir aged 10-19 years. The adjusted RORs of NPAEs were increased in male and female patients under the age of 20 years. Neuraminidase inhibitors including oseltamivir treatment could be associated with NPAEs. Therefore, these drugs should be used carefully in clinical practice.
3.Evaluation of Dermatological Disorders Caused by Anti-neoplastic Agents with an Adverse Event Spontaneous Reporting Database
Yuuki Hane ; Ryogo Umetsu ; Junko Abe ; Natsumi Ueda ; Yamato Kato ; Toshinobu Matsui ; Yumi Motooka ; Sayaka Sasaoka ; Haruna Hatahira ; Akiho Fukuda ; Misa Naganuma ; Siori Hasegawa ; Yasutomi Kinosada ; Mitsuhiro Nakamura
Japanese Journal of Drug Informatics 2016;18(3):201-208
Introduction: Dermatological disorders are one of the adverse events caused by cancer chemotherapy and are a dose-limiting factor for some anti-neoplastic agents. The severe symptoms associated with these disorders affect the patients’ quality of life (QOL). Early countermeasures for the onset of dermatological disorders associated with anti-neoplastic agent administration might be important.
Materials and Methods: We analyzed the occurrences of dermatological disorders after administration of an anti-neoplastic agent in the Food and Drug Administration Adverse Event Reporting System (FAERS), and compared the adverse event (AE) reporting ratio of the total reports. In addition, we studied the association between anti-neoplastic agents and dermatological disorders using cluster analysis. Reports for 15 anti-neoplastic agents (4 anti-neoplastic agents and 11 molecular target drugs) were analyzed.
Results: After excluding duplicate data in FAERS, 6,157,897 reports were analyzed. The number of reports that showed a dermatological disorder was 534,934. The reporting ratio of hand-foot syndrome with sorafenib and capecitabine was 11.20% and 7.05%, respectively.
Conclusions: We set the cluster number at six; cluster features obtained were as follows: (1) the reporting ratio of hand-foot syndrome was especially high, followed by the reporting ratio of rash, (2) the reporting ratio of rash and erythema was high. Similar anti-neoplastic agents may demonstrate similar occurrence tendencies of AEs and cluster features. Further studies are required to draw conclusions over these findings. Information services based on the feature of each cluster might be useful to improve patient QOL at the clinical site.
4.Postgraduate Clinical Experience and the Diagnostic Usefulness of History-taking, Physical Examination and Stat Laboratory Testing.
Tsuguya FUKUI ; Shunichi HORIKAWA ; Masashi SHIRAHAMA ; Hiroshi KOHNO ; Masanori NISHIYAMA ; Shingo ONOHARA ; Yuzoh KATAFUCHI ; Tatsuhiko KOBAYASHI ; Naoaki HIGUCHI ; Toshinobu TAKASHIMA ; Reiki KATAFUCHI ; Yukio MATSUI ; Masahiro YOSHIHARA ; Shigemi KONDOH
Medical Education 1991;22(3):139-145
5.A Survey Regarding the Price Calculation Method for New Drugs Based on the Chuikyo-Document about the NHI Drug Price List
Shiori HASEGAWA ; Yamato KATO ; Toshinobu MATSUI ; Haruna HATAHIRA ; Sayaka SASAOKA ; Yumi MOTOOKA ; Satoshi NAKAO ; Ririka MUKAI ; Kazuyo SHIMADA ; Natsumi UEDA ; Mitsuhiro NAKAMURA
Japanese Journal of Drug Informatics 2018;20(2):120-128
In Japan, the National Health Insurance (NHI) prices of new drugs are set according to the NHI Drug Price Standard (NHI Price Standard). The NHI Price Standard was notified by the Ministry of Health, Labour, and Welfare based on the ”Drug Price Calculation Criteria” proposed by the Central Social Insurance Medical Council (Chuikyo) in Japan. The NHI Price Standard affects the research and development strategy of pharmaceutical companies. In order to discover undetected relationships, the factors influencing the ”drug price” were evaluated through the association rule mining technique. We surveyed the Chuikyo‐documents about NHI price listing over the period October 27, 2006 to February 8, 2007. The number of approved new drugs was 874, while that of drugs completed (”drug price per day”) was 314. The numbers of new compounds corresponding to a drug price per day of ”below 200 yen,” ”between 200 yen and 1,000 yen,” ”between 1,000 and 10,000 yen,” and ”above or equal to 10,000 yen” were 87 (27.7%), 91 (29.0%), 79 (25.2%), and 57 (18.2%), respectively. In the association rule mining method, we observed high lift values of the combined items ”above or equal to 30,000 patients expected to be administrated” and ”drugs affecting sensory organs” in the group of drug price per day below 200 yen. The lift values of the combinations of ”biological preparations” and ”similar efficacy comparison‐based price setting (Ⅱ)” or ”below 30,000 patients expected to be administrated” and ”antineoplastic drug” in the group of ”above or equal to 10,000 yen of drug price per day” were high. These results provide a basis for the development and application of new drugs in Japan.