Adverse drug reactions of non-statin antihyperlipidaemic drugs in China from 1989 to 2019: a national database analysis

BMJ Open. 2023 May 30;13(5):e068915. doi: 10.1136/bmjopen-2022-068915.

Abstract

Objective: This study aims to understand the adverse drug reactions (ADRs) for non-statin antihyperlipidaemic drugs included in the China Anti-hyperlipidemic Drug Database.

Design: An approach of Chinese national database analysis was employed to screen clinical trials involving non-statin antihyperlipidaemic drugs from 1989 to 2019.

Setting: The database was provided by the China National Medical Products Administration Information Centre.

Participants: In total, 117 clinical studies with 8800 patients were selected from 2650 clinical trials of the Anti-hyperlipidemic Drug Database.

Interventions: The non-statin antihyperlipidaemic drugs were divided into three groups: (1) fibrates (fenofibrate, gemfibrozil, bezafibrate, etofylline clofibrate); (2) nicotinic acid and derivatives (niacin, acipimox) and (3) others (probucol, cholestyramine).

Results: The results of this study show that first, gastrointestinal symptoms were the most common reactions (6.975%), which account for approximately 50% of the reported cases with ADRs. Second, cholestyramine (16.418%) and gemfibrozil (13.158%) were the most common gastrointestinal side effect-causing non-statin antihyperlipidaemic drugs, which account for one-third of the population. Third, niacin (7.879%) and gemfibrozil (5.000%) were the most likely cause of liver disease symptoms. Finally, niacin (10.909%) and acipimox (18.847%) were the major non-statin antihyperlipidaemic drugs with skin symptoms.

Conclusion: This study revealed that gastrointestinal symptoms were the most common ADRs of fibrates, probucol and cholestyramine in the Chinese population. For nicotinic acid and derivatives, the ADRs of skin symptoms were the most common in China.

Keywords: Adverse events; CLINICAL PHARMACOLOGY; Lipid disorders.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Cholestyramine Resin / therapeutic use
  • Drug-Related Side Effects and Adverse Reactions*
  • Fibric Acids / adverse effects
  • Gemfibrozil / therapeutic use
  • Humans
  • Hypolipidemic Agents / adverse effects
  • Niacin* / adverse effects
  • Probucol / therapeutic use

Substances

  • Niacin
  • Gemfibrozil
  • Probucol
  • Cholestyramine Resin
  • Hypolipidemic Agents
  • Fibric Acids