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Sessa M, Rossi C, Mascolo A, Grassi E, Fiorentino S, Scavone C, Reginelli A, Rotondo A, Sportiello L. Suspected adverse reactions to contrast media in Campania Region (Italy): results from 14 years of post-marketing surveillance. Expert Opin Drug Saf 2015; 14:1341-51. [DOI: 10.1517/14740338.2015.1067301] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Rafaniello C, Arcoraci V, Ferrajolo C, Sportiello L, Sullo MG, Giorgianni F, Trifirò G, Tari M, Caputi AP, Rossi F, Esposito K, Giugliano D, Capuano A. Trends in the prescription of antidiabetic medications from 2009 to 2012 in a general practice of Southern Italy: a population-based study. Diabetes Res Clin Pract 2015; 108:157-63. [PMID: 25686508 DOI: 10.1016/j.diabres.2014.12.007] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2014] [Revised: 10/17/2014] [Accepted: 12/29/2014] [Indexed: 10/24/2022]
Abstract
OBJECTIVE To assess the prescribing pattern of antidiabetic drugs (AD) in a general practice of Southern Italy from 2009 to 2012, with focus on behaviour prescribing changes. METHODS This retrospective, drug utilization study was conducted using administrative databases of the Local Health Unit of Caserta (Southern Italy) including about 1 million citizens. The standardized prevalence of AD use was calculated within each study year. A sample cohort of 78,789 subjects with at least one prescription of AD was identified during the study period. RESULTS There was an overall increase of the proportion of the patients treated with monotherapy, which was significant for insulin monotherapy (from 11.2 to 14.6%, p<0.001). The proportion of patients treated with metformin remained stable (from 68.3% to 67.8%, p=0.076), while those receiving sulfonylurea dropped from 18.4% to 12.5% (p<0.001); GLP-1 analogues and DPP-4 inhibitors showed the greatest increase (from 1.2% to 6.6%, p<0.001). In the whole sample of 25,148 new AD users, metformin was the most commonly prescribed drug in monotherapy (41.9%), while insulin ranked second (13.3%). CONCLUSION This study shows a rising trend of AD monotherapy, with sulfonylureas and incretins showing the more negative and positive trend, respectively.
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Affiliation(s)
- Concetta Rafaniello
- Regional Centre of Pharmacosurveillance and Pharmacoepidemiology, Department of Experimental Medicine, Second University of Naples, via de Crecchio 7, 80138 Naples, Italy
| | - Vincenzo Arcoraci
- Department of Clinical and Experimental Medicine and Pharmacology, Pharmacology Unit, University of Messina, Via Consolare Valeria-Gazzi, 98125 Messina, Italy
| | - Carmen Ferrajolo
- Regional Centre of Pharmacosurveillance and Pharmacoepidemiology, Department of Experimental Medicine, Second University of Naples, via de Crecchio 7, 80138 Naples, Italy
| | - Liberata Sportiello
- Regional Centre of Pharmacosurveillance and Pharmacoepidemiology, Department of Experimental Medicine, Second University of Naples, via de Crecchio 7, 80138 Naples, Italy
| | - Maria Giuseppa Sullo
- Regional Centre of Pharmacosurveillance and Pharmacoepidemiology, Department of Experimental Medicine, Second University of Naples, via de Crecchio 7, 80138 Naples, Italy
| | - Francesco Giorgianni
- Department of Clinical and Experimental Medicine and Pharmacology, Pharmacology Unit, University of Messina, Via Consolare Valeria-Gazzi, 98125 Messina, Italy
| | - Gianluca Trifirò
- Department of Clinical and Experimental Medicine and Pharmacology, Pharmacology Unit, University of Messina, Via Consolare Valeria-Gazzi, 98125 Messina, Italy
| | | | - Achille P Caputi
- Department of Clinical and Experimental Medicine and Pharmacology, Pharmacology Unit, University of Messina, Via Consolare Valeria-Gazzi, 98125 Messina, Italy
| | - Francesco Rossi
- Regional Centre of Pharmacosurveillance and Pharmacoepidemiology, Department of Experimental Medicine, Second University of Naples, via de Crecchio 7, 80138 Naples, Italy
| | - Katherine Esposito
- Department of Clinical and Experimental Medicine and Surgery, Second University of Naples, Naples, Italy
| | - Dario Giugliano
- Department of Medical, Surgical, Neurological, Metabolic Sciences, and Geriatrics, Second University of Naples, Naples, Italy
| | - Annalisa Capuano
- Regional Centre of Pharmacosurveillance and Pharmacoepidemiology, Department of Experimental Medicine, Second University of Naples, via de Crecchio 7, 80138 Naples, Italy.
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Parretta E, Sottosanti L, Sportiello L, Rafaniello C, Potenza S, D'Amato S, González-González R, Rossi F, Colella G, Capuano A. Bisphosphonate-related osteonecrosis of the jaw: an Italian post-marketing surveillance analysis. Expert Opin Drug Saf 2015; 13 Suppl 1:S31-40. [PMID: 25171157 DOI: 10.1517/14740338.2014.951329] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
OBJECTIVE Although bisphosphonate (BP)-related osteonecrosis of the jaw (BRONJ) is well recognized, little is known about it in terms of pathophysiology, epidemiology or management. We analyzed all suspected BRONJ reports sent to the Italian Pharmacovigilance Adverse Event Spontaneous Reporting System (Rete Nazionale Farmacovigilanza [RNF]) to determine their pattern and add new information about this relevant issue. RESEARCH DESIGN AND METHODS All suspected BRONJ sent to the RNF between 2003 and 2011 were retrieved. After a case-by-case assessment procedure, we analyzed BP type, BP exposure time and time since last use. RESULTS Between 2003 and 2011, 555 reports of osteonecrosis of the jaw (ONJ) after BP administration were recorded in the RNF. These events occurred mostly in patients affected by cancer (77.84%) in which zoledronate was the most frequently suspected BP. Most patients experienced ONJ after long-term use of the drug (median time of BP exposure being between 1.3 and 8.8 years). Interestingly, 139 (25.05%) cases of ONJ occurred between 2 and 121 months after BP withdrawal. CONCLUSION This study shows that BRONJ can occur much earlier than hitherto reported, adds new data on BRONJ onset following ibandronate treatment and reveals that patients who cease BP-based therapy develop ONJ, raising the question of post-treatment monitoring strategies.
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Affiliation(s)
- Elisabetta Parretta
- Second University of Naples, Campania Regional Centre for Pharmacovigilance and Pharmacoepidemiology, Department of Experimental Medicine , Naples , Italy
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Abstract
INTRODUCTION Recently, incretin-based therapy was introduced for the treatment of type 2 diabetes (T2D). In particular, dipeptidyl peptidase-4 inhibitors (DPP-4i) (sitagliptin, vildagliptin, saxagliptin, linagliptin and alogliptin) play an increasing role in the management of T2D. AREAS COVERED An extensive literature search was performed to analyze the pharmacological characteristics of DPP-4i and their clinical implications. EXPERT OPINION DPP-4i present significant pharmacokinetic differences. They also differ in chemical structure, in the interaction with distinct subsites of the enzyme and in different levels of selectivity and potency of enzyme inhibition. Moreover, disparities in the effects on glycated hemoglobin, glucagon-like peptide-1 and glucagon levels and on glucose variability have been observed. However, indirect comparisons indicate that all DPP-4i have a similar safety and efficacy profiles. DPP-4i are preferred in overweight/obese and elderly patients because of the advantages of minimal or no influence on weight gain and low risk of hypoglycemia. For the same reasons, DPP-4i can be safely combined with insulin. However, currently cardiovascular outcomes related to DPP-4i are widely debated and the available evidence is controversial. Today, long-term studies are still in progress and upcoming results will allow us to better define the strengths and limits of this therapeutic class.
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Affiliation(s)
- Antonio Ceriello
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Hospital Clínic de Barcelona, Department of Endocrinology , Barcelona , Spain
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Chiappini E, Mazzantini R, Bruzzese E, Capuano A, Colombo M, Cricelli C, Di Mauro G, Esposito S, Festini F, Guarino A, Miniello VL, Principi N, Marchisio P, Rafaniello C, Rossi F, Sportiello L, Tancredi F, Venturini E, Galli L, de Martino M. Rational use of antibiotics for the management of children's respiratory tract infections in the ambulatory setting: an evidence-based consensus by the Italian Society of Preventive and Social Pediatrics. Paediatr Respir Rev 2014; 15:231-6. [PMID: 24666567 DOI: 10.1016/j.prrv.2013.11.011] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2013] [Accepted: 11/30/2013] [Indexed: 10/25/2022]
Abstract
BACKGROUND Several guidelines for the management of respiratory tract infections in children are available in Italy, as well as in other European countries and the United States of America. However, poor adherence to guidelines and the sustained inappropriate use of antibiotics have been reported. In the outpatient setting, almost half of antibiotics are prescribed for the treatment of common respiratory tract infections. In Italy the antibiotic prescription rate is significantly higher than in other European countries, such as Denmark or the Netherlands, and also the levels of antibiotic resistance for a large variety of bacteria are higher. Therefore, the Italian Society of Preventive and Social Paediatrics organised a consensus conference for the treatment of respiratory tract infections in children to produce a brief, easily readable, evidence-based document. METHODS The conference method was used, according to the National Institute of Health and the National Plan Guidelines. A literature search was performed focusing on the current guidelines for the treatment of airway infections in children aged 1 month-18 years in the ambulatory setting. RESULTS Recommendations for the treatment of acute pharyngitis, acute otitis media, sinusitis, and pneumonia have been summarized. Conditions for which antibiotic treatment should not be routinely prescribed have been highlighted. CONCLUSION This evidence-based document is intended to accessible to primary care pediatricians and general practice physicians in order to make clinical practice uniform, in accordance with the recommendations of the current guidelines.
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Affiliation(s)
- Elena Chiappini
- Department of Health Sciences, Paediatric Section, Anna Meyer Children's University Hospital, Florence, Italy
| | - Rachele Mazzantini
- Department of Health Sciences, Paediatric Section, Anna Meyer Children's University Hospital, Florence, Italy
| | - Eugenia Bruzzese
- Department of Translational Medical Science, Section of Pediatrics, University of Naples Federico II, Naples
| | - Annalisa Capuano
- Department of Experimental Medicine, Section of Pharmacology "L. Donatelli", Second University of Naples, Naples, Italy
| | | | - Claudio Cricelli
- Health Search Institute, Italian College of General Practitioners, Florence, Italy
| | - Giuseppe Di Mauro
- President Italian Society of Preventive and Social Pediatrics Primary care Pediatrician, Caserta, Italy
| | - Susanna Esposito
- Department of Pathophysiology and Transplantation, Pediatric Clinic 1, Università degli Studi di Milano, Fondazione IRCCS Ca' Grande Ospedale Maggiore Policlinico, Via Commenda 9, 20122, Milan, Italy
| | - Filippo Festini
- Department of Health Sciences, Paediatric Section, Anna Meyer Children's University Hospital, Florence, Italy
| | - Alfredo Guarino
- Department of Translational Medical Science, Section of Pediatrics, University of Naples Federico II, Naples
| | | | - Nicola Principi
- Department of Pathophysiology and Transplantation, Pediatric Clinic 1, Università degli Studi di Milano, Fondazione IRCCS Ca' Grande Ospedale Maggiore Policlinico, Via Commenda 9, 20122, Milan, Italy
| | - Paola Marchisio
- Department of Pathophysiology and Transplantation, Pediatric Clinic 1, Università degli Studi di Milano, Fondazione IRCCS Ca' Grande Ospedale Maggiore Policlinico, Via Commenda 9, 20122, Milan, Italy
| | - Concetta Rafaniello
- Department of Experimental Medicine, Section of Pharmacology "L. Donatelli", Second University of Naples, Naples, Italy
| | - Francesco Rossi
- Department of Experimental Medicine, Section of Pharmacology "L. Donatelli", Second University of Naples, Naples, Italy
| | - Liberata Sportiello
- Department of Experimental Medicine, Section of Pharmacology "L. Donatelli", Second University of Naples, Naples, Italy
| | | | - Elisabetta Venturini
- Department of Health Sciences, Paediatric Section, Anna Meyer Children's University Hospital, Florence, Italy
| | - Luisa Galli
- Department of Health Sciences, Paediatric Section, Anna Meyer Children's University Hospital, Florence, Italy
| | - Maurizio de Martino
- Department of Health Sciences, Paediatric Section, Anna Meyer Children's University Hospital, Florence, Italy
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Parretta E, Rafaniello C, Magro L, Coggiola Pittoni A, Sportiello L, Ferrajolo C, Mascolo A, Sessa M, Rossi F, Capuano A. Improvement of patient adverse drug reaction reporting through a community pharmacist-based intervention in the Campania region of Italy. Expert Opin Drug Saf 2014; 13 Suppl 1:S21-9. [DOI: 10.1517/14740338.2014.939582] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Ferrajolo C, Arcoraci V, Sullo MG, Rafaniello C, Sportiello L, Ferrara R, Cannata A, Pagliaro C, Tari MG, Caputi AP, Rossi F, Trifirò G, Capuano A. Pattern of statin use in southern italian primary care: can prescription databases be used for monitoring long-term adherence to the treatment? PLoS One 2014; 9:e102146. [PMID: 25072244 PMCID: PMC4114740 DOI: 10.1371/journal.pone.0102146] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2014] [Accepted: 06/16/2014] [Indexed: 12/14/2022] Open
Abstract
Objectives We sought to evaluate the prescribing pattern of statins according to national and regional health policy interventions and to assess specifically the adherence to the therapy in outpatient setting in Southern Italy. Methods A population-based study was performed on persons ≥15 years old, living in the catchment area of Caserta (Southern Italy), and registered in Arianna database between 2004 and 2010. Prevalence and incidence of new treatments with statins were calculated for each year and stratified by drug. Adherence to therapy was measured by Medication Possession Ratio. Sub-analyses by individual compound and type of cardiovascular prevention were performed. Results From 2004 to 2010, the one-year prevalence of statin use increased from 44.9/1,000 inhabitants to 79.8/1,000, respectively, consistently with the incidence of new use from 16.2/1,000 to 19.5/1,000, except a slight decrease after criteria reimbursement revision on 2005 (13.3/1,000). The incidence of new treatments decreased for atorvastatin, and increased for simvastatin over the study years. Overall, 43% of new users were still highly adherent to the treatment (MPR≥80%) after six months, while 26% after 4-years of follow-up. As compared with highly adherent patients, the probability to be non-adherent (MPR≤25%) at 4-years of follow-up was 26% higher for women than for men (full adj. odds ratio: 1.26; 95% CI: 1.10–1.45), and 64% higher in patients who started on primary rather than on secondary prevention (1.64; 1.29–2.07). Conclusions Prevalence and incidence of statin use increased consistently with health policy interventions. Only one-fourth of patients who newly initiated a statin were adherent to the treatment after 4-year of follow-up. Since the benefits of statins in terms of cardiovascular outcome and costs are associated with their chronic use, the identification of patient-related predictors of non-adherence such as gender, primary prevention could be suitable for physicians to improve the patients' compliance.
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Affiliation(s)
- Carmen Ferrajolo
- Campania Regional Centre of Pharmacovigilance and Pharmacoepidemiology, Experimental Medicine Department, Pharmacology Section, Second University of Naples, Naples, Italy
- Medical Informatics Department, Erasmus University Medical Centre, Rotterdam, Netherlands
- * E-mail:
| | - Vincenzo Arcoraci
- Clinical and Experimental Medicine Department, University of Messina, Messina, Italy
| | - Maria Giuseppa Sullo
- Campania Regional Centre of Pharmacovigilance and Pharmacoepidemiology, Experimental Medicine Department, Pharmacology Section, Second University of Naples, Naples, Italy
| | - Concetta Rafaniello
- Campania Regional Centre of Pharmacovigilance and Pharmacoepidemiology, Experimental Medicine Department, Pharmacology Section, Second University of Naples, Naples, Italy
| | - Liberata Sportiello
- Campania Regional Centre of Pharmacovigilance and Pharmacoepidemiology, Experimental Medicine Department, Pharmacology Section, Second University of Naples, Naples, Italy
| | - Rosarita Ferrara
- Clinical and Experimental Medicine Department, University of Messina, Messina, Italy
| | - Angelo Cannata
- Clinical and Experimental Medicine Department, University of Messina, Messina, Italy
| | | | | | | | - Francesco Rossi
- Campania Regional Centre of Pharmacovigilance and Pharmacoepidemiology, Experimental Medicine Department, Pharmacology Section, Second University of Naples, Naples, Italy
| | - Gianluca Trifirò
- Medical Informatics Department, Erasmus University Medical Centre, Rotterdam, Netherlands
- Clinical and Experimental Medicine Department, University of Messina, Messina, Italy
| | - Annalisa Capuano
- Campania Regional Centre of Pharmacovigilance and Pharmacoepidemiology, Experimental Medicine Department, Pharmacology Section, Second University of Naples, Naples, Italy
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Esposito K, Capuano A, Sportiello L, Giustina A, Giugliano D. Should we abandon statins in the prevention of bone fractures? Endocrine 2013; 44:326-33. [PMID: 23526261 DOI: 10.1007/s12020-013-9924-z] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2013] [Accepted: 03/11/2013] [Indexed: 01/07/2023]
Abstract
Osteoporosis increases dramatically with age. About 40 % of women in developed countries will experience an osteoporosis-related fracture in the course of their lifetime, with men experiencing approximately one-third to one-half the risk of women. The "lipid hypothesis of osteoporosis" claims for a role of oxidized lipids as a contributing factor in osteoporosis. On the other hand, statins are supposed to exert anabolic effects on the bone, either through their lipid-lowering action or signal pathways that are independent of their effects on lipid levels. The epidemiological evidence seems to suggest that higher triglycerides may give some protection against fracture, although no association with reduced fracture risk has been reported between lipid-lowering drug (except statins) users and non-users. The epidemiological evidence for a role of statins in osteoporosis is strong, with a lower fracture risk ranging from 30 to 40 % in statin users versus non-users. However, some pitfalls inherent to observational studies (high heterogeneity, residual confounding, potential publication bias) and the lack of association in randomized trials suggest caution. At the moment, the evidence for a role of statins in prevention of osteoporosis is insufficient to recommend starting statin therapy with the aim to prevent osteoporosis.
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Affiliation(s)
- Katherine Esposito
- Department of Cardio-Thoracic and Respiratory Sciences, Second University of Naples, Endocrine and Diabetes Unit, Piazza L. Miraglia 2, 80138, Naples, Italy,
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Capuano A, Sportiello L, Maiorino MI, Rossi F, Giugliano D, Esposito K. Dipeptidyl peptidase-4 inhibitors in type 2 diabetes therapy--focus on alogliptin. Drug Des Devel Ther 2013; 7:989-1001. [PMID: 24068868 PMCID: PMC3782406 DOI: 10.2147/dddt.s37647] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Type 2 diabetes mellitus is a complex and progressive disease that is showing an apparently unstoppable increase worldwide. Although there is general agreement on the first-line use of metformin in most patients with type 2 diabetes, the ideal drug sequence after metformin failure is an area of increasing uncertainty. New treatment strategies target pancreatic islet dysfunction, in particular gut-derived incretin hormones. Inhibition of the enzyme dipeptidyl peptidase-4 (DPP-4) slows degradation of endogenous glucagon-like peptide-1 (GLP-1) and thereby enhances and prolongs the action of the endogenous incretin hormones. The five available DPP-4 inhibitors, also known as 'gliptins' (sitagliptin, vildagliptin, saxagliptin, linagliptin, alogliptin), are small molecules used orally with similar overall clinical efficacy and safety profiles in patients with type 2 diabetes. The main differences between the five gliptins on the market include: potency, target selectivity, oral bioavailability, long or short half-life, high or low binding to plasma proteins, metabolism, presence of active or inactive metabolites, excretion routes, dosage adjustment for renal and liver insufficiency, and potential drug-drug interactions. On average, treatment with gliptins is expected to produce a mean glycated hemoglobin (HbA1c) decrease of 0.5%-0.8%, with about 40% of diabetic subjects at target for the HbA1c goal <7%. There are very few studies comparing DPP-4 inhibitors. Alogliptin as monotherapy or added to metformin, pioglitazone, glibenclamide, voglibose, or insulin therapy significantly improves glycemic control compared with placebo in adult or elderly patients with inadequately controlled type 2 diabetes. In the EXAMINE trial, alogliptin is being compared with placebo on cardiovascular outcomes in approximately 5,400 patients with type 2 diabetes. In clinical studies, DPP-4 inhibitors were generally safe and well tolerated. However, there are limited data on their tolerability, due to their relatively recent marketing approval. Alogliptin will be used most when avoidance of hypoglycemic events is paramount, such as in patients with congestive heart failure, renal failure, and liver disease, and in the elderly.
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Affiliation(s)
- Annalisa Capuano
- Department of Experimental Medicine, Second University of Naples, Naples, Italy
| | - Liberata Sportiello
- Department of Experimental Medicine, Second University of Naples, Naples, Italy
| | - Maria Ida Maiorino
- Department of Medical, Surgical, Neurological, Metabolic Sciences, and Geriatrics, Second University of Naples, Naples, Italy
| | - Francesco Rossi
- Department of Experimental Medicine, Second University of Naples, Naples, Italy
| | - Dario Giugliano
- Department of Medical, Surgical, Neurological, Metabolic Sciences, and Geriatrics, Second University of Naples, Naples, Italy
| | - Katherine Esposito
- Department of Clinical and Experimental Medicine and Surgery, Second University of Naples, Naples, Italy
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Ruggiero S, Rafaniello C, Bravaccio C, Grimaldi G, Granato R, Pascotto A, Sportiello L, Parretta E, Rinaldi B, Panei P, Rossi F, Capuano A. Safety of attention-deficit/hyperactivity disorder medications in children: an intensive pharmacosurveillance monitoring study. J Child Adolesc Psychopharmacol 2012; 22:415-22. [PMID: 23234585 DOI: 10.1089/cap.2012.0003] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
OBJECTIVE Our intensive pharmacosurveillance monitoring program was performed to increase the number of adverse drug reactions (ADRs) recorded in the Italian spontaneous reporting database, and to systematically collect more thorough data about atomoxetine (ATX) and methylphenidate (MPH) safety in the pediatric setting. METHODS From September 2007 to October 2010, 1841 youth were enrolled in the Italian Attention- Deficit/Hyperactivity Disorder Register, but we report here on the 76 children from the five Reference Prescription Centers in Campania, an Italian region where we administered our systematic adverse event checklist. RESULTS Among our cohort, 68 children received a prescription of ATX and 8 received a prescription of MPH. Most children were male and between 10 and 13 years of age, had a diagnosis of attention-deficit/hyperactivity disorder-combined (ADHD-C) and had learning disability as the main comorbidity. Most ADRs reported to the Italian spontaneous reporting database occurred in patients from Campania. Twenty-five experienced at least 1 ADR for a total of 40 ADRs reported to the Italian drug agency. Most ADRs were common and not serious, and resolved completely. Weight loss was the most frequently reported ADR. Only two ADRs were unexpected and only one was uncommon. Sixteen ADRs resulted in permanent drug withdrawal. Based on the Naranjo algorithm, 25 ADRs were considered "probable" and 15 were considered "possible." CONCLUSIONS Although our data provide reassurance of the safety of ATX and MPH, several unexpected or uncommon ADRs (hepatomegaly, suicidal ideation, weight gain, or drug interactions) were identified by our intensive pharmacosurveillance monitoring program. Our results show that an intensive pharmacosurveillance monitoring program that involves pharmacovigilance centers and clinicians can improve the collection of information on drug safety in children.
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Affiliation(s)
- Simona Ruggiero
- Department of Experimental Medicine, Section of Pharmacology Leonardo Donatelli, Center of Pharmacosurveillance and Pharmacoepidemiology, Faculty of Medicine and Surgery, Second University of Naples, Naples, Italy.
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Rafaniello C, Ianniello B, Sullo N, De Rosa S, Sportiello L, Rossi F, D'Agostino B, Capuano A. [Hospital consumption of antibiotics at the Policlinico Hospital of the Second University of Naples: results of retrospective data collection]. Infez Med 2010; 18:235-242. [PMID: 21196817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
In the therapeutic field, analysis of antibiotics consumption and use is of great importance: it is considered a necessary prerequisite for initiating measures to rationalize the use of antibiotics, but also to limit bacterial resistance. In this light, we conducted an observational study on antibiotics consumption at the Policlinico University Hospital in Naples to evaluate the prescription of antibiotics in the hospital's four main divisions. We used the Defined Daily Dose (DDD) as a measure of antibiotics consumption, and collected data retrospectively from 2006 to 2007. Our findings clearly show a 23.3% increase in antibiotics consumption in 2007 vs 2006. The classes of antibiotics experiencing the greatest percentage increases were penicillins and other beta-lactams, quinolones and glycopeptides. In particular, among other beta-lactams (J01D) in 2007 was the consumption of third-generation cephalosporins and carbapenems. The surgical division showed the largest increase in use of antibiotics, while in intensive care we found a reduction. Our data suggest consumption data should be compared with information on prescriptions and costs so as to monitor more closely the consumption of antibiotics and thus rationalize their use with a view to reducing the phenomenon of bacterial resistance. Finally, it would be useful to launch a training program for the proper use of antibiotics in our University Hospital.
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Affiliation(s)
- Concetta Rafaniello
- Dipartimento di Medicina Sperimentale, Centro di Farmacovigilanza e Farmacoepidemiologia, Seconda Universita di Napoli, Italy
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Sportiello L, Cammarota S, de Portu S, Sautebin L. Notification of undesirable effects of cosmetics and toiletries. Pharmacol Res 2009; 59:101-6. [DOI: 10.1016/j.phrs.2008.10.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2008] [Revised: 10/09/2008] [Accepted: 10/28/2008] [Indexed: 10/21/2022]
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