1. Drug-Induced Liver Injury Associated With Antidepressive Psychopharmacotherapy: An Explorative Assessment Based on Quantitative Signal Detection Using Different MedDRA Terms.
- Author
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Gahr, Maximilian, Zeiss, René, Lang, Dirk, Connemann, Bernhard J., Hiemke, Christoph, and Schönfeldt‐Lecuona, Carlos
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ANTIDEPRESSANTS ,HEPATOTOXICOLOGY ,LIVER ,PHARMACOLOGY ,PSYCHOPHYSICS ,DATA mining ,QUANTITATIVE research ,SECONDARY analysis ,DATA analysis software ,DESCRIPTIVE statistics ,ODDS ratio ,PHARMACODYNAMICS - Abstract
Drug-induced liver injury is a major problem of pharmacotherapy and is also frequent with antidepressive psychopharmacotherapy. However, there are only few studies using a consistent methodologic approach to study hepatotoxicity of a larger group of antidepress ants. We performed a quantitative signal detection analysis using data from the Uppsala Monitoring Centre from the WHO that records adverse drug reaction (ADR) data from worldwide sources; we retrieved substance- and country-specific (Australia, France, Germany, Italy, Spain, the United Kingdom, and the United States) ADR data and calculated reporting odds ratios as measures for disproportionality within a case/noncase approach. To allow for identification of agents that cause severe forms of hepatotoxic ADRs, we used 2 terms of the MedDRA ('drug-related hepatic disorders-comprehensive search' [DRHD-CS] and '... -severe events only' [DRHD-SEO]). Distribution of signals was heterogeneous throughout the different data sets, and consistent findings were present for only a few substances: agomelatine (AGM) and tianeptine as well as both positive control agents (amineptine, nefazodone) generated signals related to DRHD-CS and DRHD-SEO in all analyzed data sets. Tri- and tetracyclic antidepressants (here amitriptyline, clomipramine, mianserin, mirtazapine, trimipramine) were associated with hepatotoxicity in several data sets. Using 2 MedDRA terms did not allow for detection of agents that cause severe hepatotoxic ADR. Our results support the findings of previous, primarily literature-based, systematic analyses of hepatotoxicity related to antidepressive psychopharmacotherapy. No new safety information could be generated. Application of 2 MedDRA terms did not increase the substance-specific safety information. [ABSTRACT FROM AUTHOR]
- Published
- 2016
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