可致残!氟喹诺酮类药物副作用严重

2017-04-13 佚名 国家食药监总局

加拿大卫生部在美国食品药品管理局(FDA)对全身性(口服或注射)氟喹诺酮类药物进行审查之后,启动了一项安全性审查。基于FDA关于氟喹诺酮类药物与持续性(停止氟喹诺酮类药物后持续30天或以上)和致残副作用相关的审查结果,此次安全性审查的重点是已知严重副作用,包括:肌腱炎/肌腱病变(肌腱炎症)、周围神经病变(累及神经的损伤或异常)、重症肌无力(慢性自身免疫性疾病)恶化、超敏反应和严重皮肤反应、精神障碍

加拿大卫生部在美国食品药品管理局(FDA)对全身性(口服或注射)氟喹诺酮类药物进行审查之后,启动了一项安全性审查。基于FDA关于氟喹诺酮类药物与持续性(停止氟喹诺酮类药物后持续30天或以上)和致残副作用相关的审查结果,此次安全性审查的重点是已知严重副作用,包括:肌腱炎/肌腱病变(肌腱炎症)、周围神经病变(累及神经的损伤或异常)、重症肌无力(慢性自身免疫性疾病)恶化、超敏反应和严重皮肤反应、精神障碍、抑郁与自杀/自伤、惊厥(癫痫发作)、血管疾病、光毒性(光敏感性)和视觉障碍。

本次审查期间,加拿大卫生部识别了115份与氟喹诺酮类药物使用相关的持续性和致残性副作用报告。在78份报告中,使用氟喹诺酮类药物与持续性致残很可能(29例)或可能(49例)相关。其余病例提供的信息不足,或者持续性致残报告不太可能与使用氟喹诺酮类药物有关。大多数副作用病例来自115份报告,并且与持续性致残相关,包括肌腱炎/肌腱病变(肌腱炎症或异常)、周围神经病变(累及脊髓和脑以外神经的损伤或异常)和中枢神经系统疾病(与脑疾病有关)。现行安全性信息包含肌腱病变、周围神经病变和中枢神经系统的副作用。但是,所有氟喹诺酮类药物的安全性信息均不包含上述事件持续的可能性。关于氟喹诺酮类药物使用相关副作用的持续性和致残性,科学和医学文献中的信息极少,但支持氟喹诺酮类药物使用与持续性致残相关,特别是在肌腱病变和周围神经病变等副作用方面。

鉴此,加拿大卫生部认为,一些与氟喹诺酮类药物使用有关的已知副作用可能具有持续性和/或致残性,特别是肌腱炎/肌腱病变、周围神经病变和中枢神经系统疾病。考虑到氟喹诺酮类药物在加拿大的高使用率和审查的信息,评估认为这些属于罕见副作用。加拿大卫生部建议更新所有氟喹诺酮类药物的安全性信息,纳入上述罕见但严重的风险信息。加拿大卫生部与生产商合作,更新了加拿大所有已上市的全身给药(口服或注射)氟喹诺酮类药物的安全性信息。此外,将发布和分发信息更新和医务人员告知函,进一步向加拿大民众和医务人员通告上述信息。

此外,加拿大卫生部还与药品安全性和有效性网络(DSEN)以及加拿大药物和卫生技术局(CADTH)共同合作,进一步开展研究,更好地了解氟喹诺酮类药物在加拿大的应用。2016年10月6日,加拿大卫生部已经成立了抗感染治疗科学专家咨询小组,讨论氟喹诺酮类药物使用相关风险。该专家组建议,更新氟喹诺酮类药物的安全性信息,发布和分发风险通告,进一步向加拿大民众和医务人员通告上述潜在风险:一些已知副作用,特别是肌腱炎/肌腱病变、周围神经病变和中枢神经系统疾病可能具有持续性和/或致残性。

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  4. 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  5. 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level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib06iaV3D9Tg5Kym1A9qicflExZYSdibSZBHDyicKZZj37w4jR44fPa9DI3mVLObHAxzntpTAbwxeHvviclcw8coNrDge/0, createdBy=6dc22001775, createdName=春暖花开8785, createdTime=Fri Apr 14 14:11:39 CST 2017, time=2017-04-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=187292, encodeId=277a18e29274, content=文章很好,值得分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzdAIB7UwTkHt6fQkBP8ictliaXtc5gCUmYdAW1sAETC2nhO3q6YjRHkUibyOCtP8ibmXNObTyd63A076/0, createdBy=d4111948983, createdName=1e10c84am36(暂无匿称), createdTime=Fri Apr 14 08:18:39 CST 2017, time=2017-04-14, status=1, ipAttribution=), 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    2017-04-19 lou.minghong

    这么严重啊

    0

  6. 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level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib06iaV3D9Tg5Kym1A9qicflExZYSdibSZBHDyicKZZj37w4jR44fPa9DI3mVLObHAxzntpTAbwxeHvviclcw8coNrDge/0, createdBy=6dc22001775, createdName=春暖花开8785, createdTime=Fri Apr 14 14:11:39 CST 2017, time=2017-04-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=187292, encodeId=277a18e29274, content=文章很好,值得分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzdAIB7UwTkHt6fQkBP8ictliaXtc5gCUmYdAW1sAETC2nhO3q6YjRHkUibyOCtP8ibmXNObTyd63A076/0, createdBy=d4111948983, createdName=1e10c84am36(暂无匿称), createdTime=Fri Apr 14 08:18:39 CST 2017, time=2017-04-14, status=1, ipAttribution=), 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    2017-04-15 明天会更好!

    学习过了,很好值得学习!

    0

  7. 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  8. 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    2017-04-14 春暖花开8785

    副作用这么严重?

    0

  9. 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level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib06iaV3D9Tg5Kym1A9qicflExZYSdibSZBHDyicKZZj37w4jR44fPa9DI3mVLObHAxzntpTAbwxeHvviclcw8coNrDge/0, createdBy=6dc22001775, createdName=春暖花开8785, createdTime=Fri Apr 14 14:11:39 CST 2017, time=2017-04-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=187292, encodeId=277a18e29274, content=文章很好,值得分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzdAIB7UwTkHt6fQkBP8ictliaXtc5gCUmYdAW1sAETC2nhO3q6YjRHkUibyOCtP8ibmXNObTyd63A076/0, createdBy=d4111948983, createdName=1e10c84am36(暂无匿称), createdTime=Fri Apr 14 08:18:39 CST 2017, time=2017-04-14, status=1, ipAttribution=), 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    2017-04-14 1e10c84am36(暂无匿称)

    文章很好,值得分享

    0

  10. 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GetPortalCommentsPageByObjectIdResponse(id=187213, encodeId=ec5518e2135d, content=医生也不是完全清楚,背后全是药企利益根源在作祟, beContent=null, objectType=article, channel=null, level=null, likeNumber=43, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTL492ddYrqianjISVlrF2LaHxx8vGa8B1Vy2g3hKTLtHXfMNDjPq1Iy0U2XwSkLj5ndQvjl4npefzg/132, createdBy=0ac123695, createdName=老虎不发微, createdTime=Thu Apr 13 23:47:30 CST 2017, time=2017-04-13, status=1, ipAttribution=)]
    2017-04-13 老虎不发微

    医生也不是完全清楚,背后全是药企利益根源在作祟

    0

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