卡格列净相关不良反应病例报道的文献分析

Analysis of Adverse Drug Reaction Case Reports for Canagliflozin

目的:探讨卡格列净相关不良反应(ADR)的发生特点,为临床安全使用该药提供参考。方法:计算机检索CNKI、万方数据、VIP、PubMed、Sciencedirect、Web of Science等数据库,收集国内外卡格列净相关ADR的病例报道,对患者性别、年龄、原患疾病,卡格列净用药剂量、合并用药,不良反应发生时间、累及系统/器官及临床表现、治疗与转归等进行统计分析。结果:共收集文献32篇,病例34例。卡格列净相关ADR病例女性多于男性;以50岁以上(55.88%)多见;ADR多发生于用药后3个月内(67.64%);主要涉及代谢和营养障碍(58.82%)、泌尿生殖系统损害(17.65%)、消化系统损害(14.71%)等,其中以酮症酸中毒、急性肾损伤、泌尿生殖系统感染、急性胰腺炎较为严重。结论:临床使用卡格列净应加强用药监测,警惕ADR的发生,尤其对于老年、肾功能不全、泌尿生殖系统围手术期及出现急性代谢紊乱的患者。

Objective:To investigate the characteristics of adverse drug reactions(ADR) induced by canagliflozin and provide reference for clinical rational drug use. Methods:Using computer retrieval the database such as CNKI, Wanfang, VIP, PubMed, Sciencedirect, Web of Science, the adverse reactions of canagliflozin were collected and the items of the patient’s gender, age, original disease, dosage, combined medication, adverse reaction time, involvement system/organ and clinical manifestations, treatment and outcome, etc were analyzed. The retrieval time was from the establishment of each database to February 2020. Results:32 articles and 34 cases were collected. It showed that the ADR of canagliflozin preparation in women more than men. The majority of Canagliflozin-induced ADRs in the people were over 50-year-old(55.88%). The major adverse reactions occurred in three months after the medication(67.64%). ADR involving was major in metabolic and nutritional disorders(58.82%), urinary and reproductive system damage(17.65%) and digestive system damage(14.71%), the more serious ADRs were diabetic ketoacidosis,acute kidney injury, urinary and reproductive system infection and acute pancreatitis. Conclusion: In clinical use of canagliflozin should be strengthened monitoring of medication, especially for elderly patients, renal insufficiency patients, Perioperative patients of genitourinary system and patients with acute metabolic disorders, alerting the occurance of ADRs.