A Comparison of Active Pharmacovigilance Strategies Used to Monitor Adverse Events to Antiviral Agents: A Systematic Review

Autores da FMUP

• Renato Ivo Ferreira Da Silva

  Autor

• Matilde Filipa Monteiro Soares

  Autor

• Bernardo Manuel De Sousa Pinto

  Autor

• Jorge Manuel Da Silva Junqueira Polónia

  Autor

• Fernanda Inês De Carvalho Pereira Ribeiro

  Autor

Participantes de fora da FMUP

• Reis-Pardal, J
• Pinto, M
• Morato, M

Unidades de investigação

• Laboratório Associado RISE- Rede de Investigação em Saúde

  

  Investigador

  Fernando Carlos De Landér Schmitt

• Medicina

• Medicina da Comunidade, Informação e Decisão em Saúde

• RISE-Health

  

  Investigador

  Fernando Carlos De Landér Schmitt

Abstract

IntroductionThe safety of antiviral agents in real-world clinical settings is crucial, as pre-marketing studies often do not capture all adverse events (AE). Active pharmacovigilance strategies are essential for detecting and characterising these AE comprehensively.ObjectiveThe aim of this study was to identify and characterise active pharmacovigilance strategies used in real-world clinical settings for patients under systemic antiviral agents, focusing on the frequency of AE and the clinical data sources used.MethodsWe conducted a systematic review by searching three electronic bibliographic databases targeting observational prospective active pharmacovigilance studies, phase IV clinical trials for post-marketing safety surveillance, and interventional studies assessing active pharmacovigilance strategies, focusing on individuals exposed to systemic antiviral agents.ResultsWe included 36 primary studies, predominantly using Drug Event Monitoring (DEM), with a minority employing sentinel sites and registries. Human immunodeficiency virus (HIV) was the most common condition, with the majority using DEM. Within the DEM, there was a wide range of incidences of patients experiencing at least one AE, and most of these studies used one or two data sources. Sentinel site studies were less common, with two on hepatitis C virus (HCV) and one on HIV, each relying on one or two data sources. The single study using a registry focusing on HIV therapy reported using just one data source. Patient interviews were the most common data source, followed by medical records and laboratory tests. The quality of the studies was considered good in 18/36, fair in 1/36, and poor in 17/36 studies.ConclusionDEM was the predominant pharmacovigilance strategy, employing multiple data sources, and appears to increase the likelihood of detecting higher AE incidence. Establishing such a framework would facilitate a more detailed and consistent approach across different studies and settings.

Keywords

• NEURAMINIDASE INHIBITOR PERAMIVIR; LANINAMIVIR OCTANOATE HYDRATE; DRUG SAFETY SURVEILLANCE; ANTIRETROVIRAL THERAPY; POSTMARKETING SAFETY; HIV PATIENTS; OSELTAMIVIR; INFLUENZA; MEDICINES; CHILDREN