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Current Drug Safety

Editor-in-Chief

ISSN (Print): 1574-8863
ISSN (Online): 2212-3911

Research Article

Retrospective Observational Study to Evaluate Causality, Preventability and Severity of Adverse Drug Reaction Associated with Anticancer Drugs in a Tertiary Care Hospital in Northern India

Author(s): Ravi Thakur, Jagminder Kaur Bajaj, Archana Dutta and Shabir Sidhu*

Volume 17, Issue 4, 2022

Published on: 25 March, 2022

Page: [335 - 343] Pages: 9

DOI: 10.2174/1574886317666220216100515

Price: $65

Abstract

Background: Chemotherapy has high efficacy, but it is associated with several adverse drug reactions (ADRs).

Objectives: A retrospective observational study to explore the prevalence, causality, and preventability of ADRs of anticancer agents was conducted.

Methods: The study was carried out at Punjab Institute of Medical Sciences Jalandhar, Punjab after obtaining IEC approval. The data was collected from cancer patients undergoing treatment at the hospital. The causality assessment of the collected data was done by using WHO causality assessment criteria. The preventability and severity of the reported ADRs were also assessed.

Results: From 50 medical records, a total of 47 ADRs were recorded among 25 patients, out of which 16 were females and the rest were males. The cancer cases observed were breast carcinoma, leukaemia, lung, colon, and ovarian cancer. The highest number of ADRs were observed with alkylating agents, followed by taxanes, antimetabolites, kinase inhibitors, and monoclonal antibodies. The most affected organ systems were the gastrointestinal system, blood, and lymphatic system. According to the causality assessment, the majority of the ADRs were of the "possible" category. Preventability analysis showed that 85.11% of ADRs were unavoidable reactions, while 14.89% of ADRs were possibly avoidable. Severity analysis of ADRs showed that 87.23% of ADRs were mild and 12.77% were of moderate severity. The majority of the ADRs were unavoidable and mild to moderate in severity.

Conclusion: Since the majority of the ADRs were of the unavoidable category, it indicates that the treatment regimens are acceptable as per the current clinical management of cancer patients.

Keywords: Pharmacovigilance, causality assessment, adverse drug reactions, chemotherapy, preventability assessment, severity assessment.

Graphical Abstract
[1]
Tewari D, Rawat P, Singh PK. Adverse drug reactions of anticancer drugs derived from natural sources. Food Chem Toxicol 2019; 123: 522-35.
[http://dx.doi.org/10.1016/j.fct.2018.11.041] [PMID: 30471312]
[2]
World Health Organization. The importance of pharmacovigilance: Safety monitoring of medicinal products. 2021. Available from: https://apps.who.int/iris/bitstream/handle/10665/42493/a75646.pdf?sequence=1&isAllowed=y
[3]
Lau PM, Stewart K, Dooley M. The ten most common Adverse Drug Reactions (ADRs) in oncology patients: Do they matter to you? Support Care Cancer 2004; 12(9): 626-33.
[http://dx.doi.org/10.1007/s00520-004-0622-5] [PMID: 15064936]
[4]
Chopra D, Rehan HS, Sharma V, Mishra R. Chemotherapy-induced adverse drug reactions in oncology patients: A prospective observational survey. Indian J Med Paediatr Oncol 2016; 37(1): 42-6.
[http://dx.doi.org/10.4103/0971-5851.177015] [PMID: 27051157]
[5]
Lavan AH, O’Mahony D, Buckley M, O’Mahony D, Gallagher P. Adverse drug reactions in an onco-logical population: Prevalence, predictability, and preventability. Oncologist 2019; 24(9): e968-77.
[http://dx.doi.org/10.1634/theoncologist.2018-0476] [PMID: 30833488]
[6]
Baldo P, Fornasier G, Ciolfi L, Sartor I, Francescon S. Pharmacovigilance in oncology. Int J Clin Pharm 2018; 40(4): 832-41.
[http://dx.doi.org/10.1007/s11096-018-0706-9] [PMID: 30069667]
[7]
Sharma M, Loh KP, Nightingale G, Mohile SG, Holmes HM. Polypharmacy and potentially inappro-priate medication use in geriatric oncology. J Geriatr Oncol 2016; 7(5): 346-53.
[http://dx.doi.org/10.1016/j.jgo.2016.07.010] [PMID: 27498305]
[8]
Hartwig SC, Siegel J, Schneider PJ. Preventability and severity assessment in reporting adverse drug reactions. Am J Hosp Pharm 1992; 49(9): 2229-32.
[http://dx.doi.org/10.1093/ajhp/49.9.2229] [PMID: 1524068]
[9]
Geer MI, Koul PA, Tanki SA, Shah MY. Frequency, types, severity, preventability and costs of ad-verse drug reactions at a tertiary care hospital. J Pharmacol Toxicol Methods 2016; 81: 323-34.
[http://dx.doi.org/10.1016/j.vascn.2016.04.011] [PMID: 27109493]
[10]
Mallik S, Palaian S, Ojha P, Mishra P. Pattern of adverse drug reactions due to cancer chemotherapy in a tertiary care teaching hospital in Nepal. Pak J Pharm Sci 2007; 20(3): 214-8.
[PMID: 17545106]
[11]
Wahlang JB, Laishram PD, Brahma DK, Sarkar C, Lahon J, Nongkynrih BS. Adverse drug reactions due to cancer chemotherapy in a tertiary care teaching hospital. Ther Adv Drug Saf 2017; 8(2): 61-6.
[http://dx.doi.org/10.1177/2042098616672572] [PMID: 28255433]
[12]
Sharma PK, Misra AK, Gupta A, Singh S, Dhamija P, Pareek P. A retrospective analysis of reporting of adverse drug reactions to oncology drugs: An experience from a national center of clinical excel-lence. Indian J Pharmacol 2018; 50(5): 273-8.
[http://dx.doi.org/10.4103/ijp.IJP_544_17] [PMID: 30636831]
[13]
Hajian-Tilaki K. Sample size estimation in epidemiologic studies. Caspian J Intern Med 2011; 2(4): 289-98.
[PMID: 24551434]
[14]
Sharma A, Kumari KM, Manohar HD, Bairy KL, Thomas J. Pattern of adverse drug reactions due to cancer chemotherapy in a tertiary care hospital in South India. Perspect Clin Res 2015; 6(2): 109-15.
[http://dx.doi.org/10.4103/2229-3485.154014] [PMID: 25878957]
[15]
Patidar D, Rajput MS, Nirmal NP, Savitri W. Implementation and evaluation of adverse drug reaction monitoring system in a tertiary care teaching hospital in Mumbai, India. Interdiscip Toxicol 2013; 6(1): 41-6.
[http://dx.doi.org/10.2478/intox-2013-0008] [PMID: 24170978]
[16]
Tandon VR, Mahajan V, Khajuria V, Gillani Z. Under-reporting of adverse drug reactions: A chal-lenge for pharmacovigilance in India. Indian J Pharmacol 2015; 47(1): 65-71.
[http://dx.doi.org/10.4103/0253-7613.150344] [PMID: 25821314]
[17]
Rout A, Panda RK, Mishra V, Parida P, Mohanty S. Pharmacovigilance in cancer chemotherapy in regional cancer center of Eastern India: Prospective observational study. Int J Basic Clin Pharmacol 2017; 6(8): 1910-6.
[http://dx.doi.org/10.18203/2319-2003.ijbcp20173148]
[18]
Ueno H, Ikeda M, Ueno M, et al. Phase I/II study of nab-paclitaxel plus gemcitabine for chemothera-py-naive Japanese patients with metastatic pancreatic cancer. Cancer Chemother Pharmacol 2016; 77(3): 595-603.
[http://dx.doi.org/10.1007/s00280-016-2972-3] [PMID: 26842789]
[19]
Takahashi S, Kiyota N, Yamazaki T, et al. A Phase II study of the safety and efficacy of lenvatinib in patients with advanced thyroid cancer. Future Oncol 2019; 15(7): 717-26.
[http://dx.doi.org/10.2217/fon-2018-0557] [PMID: 30638399]
[20]
Rogers BB, Cuddahy T, Briscella C, Ross N, Olszanski AJ, Denlinger CS. Oxaliplatin: Detection and management of hypersensitivity reactions. Clin J Oncol Nurs 2019; 23(1): 68-75.
[http://dx.doi.org/10.1188/19.CJON.68-75] [PMID: 30682002]

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