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首页> 外文期刊>The Journal of Clinical Pharmacology: Official Journal of the American College of Clinical Pharmacology >The Association Between Concurrence of Infection and the Onset of Severe Eruption or Liver Injury in Patients Using Antipyretic Analgesics: A Matched, Nested Case-Control Study
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The Association Between Concurrence of Infection and the Onset of Severe Eruption or Liver Injury in Patients Using Antipyretic Analgesics: A Matched, Nested Case-Control Study

机译：使用解热镇痛患者的感染和严重喷发或肝损伤的同时性的关联：A匹配，嵌套病例对照研究

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摘要

Stevens-Johnson syndrome (SJS) and toxic epidermal necrosis (TEN) or drug-induced liver injury (DILI) are severe drug-induced reactions,known as idiosyncratic drug reactions. It is believed that immune response can lead to these severe adverse drug reactions. Our previous analysis of the Japanese Spontaneous Drug Reaction database suggested that the onset of SJS/TEN and DILI was strongly associated with infection. Hence, we conducted a matched, nested case-control study to elucidate the association between concurrent infection and the onset of SJS/TEN or liver injury in patients prescribed antipyretic analgesics.We extracted 4 112 055 patients who were prescribed antipyretic analgesics between January 2014 and December 20l5.Amongst them,553 (0.01%) were diagnosed with SJS/TEN and 12 606 (0.3%) with liver injury. In a matched,nested case-control study, 131 and 2847 cases matched for SJS/TEN or liver injury, respectively. For each case, 3 controls were randomly matched with the case for age at index date and sex. In the conditional logistic regression analysis,there was a significant association between the combination of infection and antipyretic analgesics and the onsetofSJS/TEN or liver injury (SJS/TEN:adjusted OR, 5.59; 95%CI, 2.01-15.51; liver injury:adjusted OR,2.79;95%CI,2.24-3.46).Although it was not possible to distinguish whether the associations were caused by the infection or were a direct consequence of the antibiotic agents, our findings may help to increase awareness of the possibility of the increased onset of idiosyncratic drug reactions (SJS/TEN and liver injury) in antipyretic analgesic users because of infections.
机译：史蒂文斯-约翰逊综合征（SJS）和中毒性表皮坏死（TEN）或药物性肝损伤（DILI）是严重的药物诱导反应，称为特异性药物反应。据信，免疫反应可导致这些严重的药物不良反应。我们之前对日本自发药物反应数据库的分析表明，SJS/TEN和DILI的发病与感染密切相关。因此，我们进行了一项配对、嵌套的病例对照研究，以阐明服用解热镇痛药的患者并发感染与SJS/TEN或肝损伤发病之间的关系。我们提取了2014年1月至2015年12月期间服用解热镇痛药的4112055名患者。其中553例（0.01%）诊断为SJS/TEN，12606例（0.3%）诊断为肝损伤。在一项匹配的嵌套病例对照研究中，131例和2847例分别与SJS/TEN或肝损伤匹配。对于每个病例，3个对照组与病例在索引日期的年龄和性别随机匹配。在条件logistic回归分析中，感染和解热镇痛药的组合与onsetofSJS/TEN或肝损伤之间存在显著相关性（SJS/TEN：调整后的or，5.59；95%可信区间，2.01-15.51；肝损伤：调整后的or，2.79；95%可信区间，2.24-3.46）。虽然无法区分这些关联是由感染引起的，还是抗生素制剂的直接后果，但我们的发现可能有助于提高人们对解热镇痛药使用者因感染而增加特异性药物反应（SJS/TEN和肝损伤）发生的可能性的认识。

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