2016 年 42 巻 11 号 p. 717-726
Little research has been published on the influence of deferasirox (DFX) (an iron chelating agent), or its use concomitantly with other drugs and acute renal dysfunction. We used signal detection to determine the risk of acute renal failure associated with DFX and concomitant drug use using the Japanese Adverse Drug Event Report database (JADER). When using the proportional reporting ratio (PRR) as an evaluation index, the following concomitant drugs were found by signal detection: DFX-cyclosporin A (CyA) (risk ratio associated with concomitant use: 2.53); DFX-loxoprofen sodium (risk ratio associated with concomitant use: 2.48); DFX-diclofenac sodium (risk ratio associated with concomitant use: 3.31); DFX-amphotericin B (risk ratio associated with concomitant use: 2.88); DFX-anti-human thymocyte immunoglobulin (risk ratio associated with concomitant use: 2.13). When we used the reporting odds ratio (ROR) as an evaluation index, we found the concomitant usage risk of DFX-CyA (adjusted ROR: 24.9, 95% confidence interval (CI): 14.8-42.0).
We found concomitant drugs using signal detection and evaluated them by performing a case-control study. We investigated cases that occurred between June 2008 and December 2014 at Tosei General Hospital in Aichi, Japan (701 beds). Of 29 total cases where DFX was administered, there were a higher number of cases where cyclosporine was administered concomitantly in the acute renal failure group compared with the group with no onset of acute renal failure (odds ratio: 16.00, 95% CI: 1.58-162.10).
Our study suggests the possibility that the concomitant use of DFX and CyA might be associated with an increased risk of acute renal failure.
