Age-Associated Risk of Liver-Related Adverse Drug Reactions

Yan-Zhong Han; Yu-Ming Guo; Peng Xiong; Fei-Lin Ge; Jing Jing; Ming Niu; Xu Zhao; Zhao-Fang Bai; Hai-Bo Song; Xiao-He Xiao; Jia-Bo Wang

doi:10.3389/fmed.2022.832557

Age-Associated Risk of Liver-Related Adverse Drug Reactions

Front Med (Lausanne). 2022 Mar 17:9:832557. doi: 10.3389/fmed.2022.832557. eCollection 2022.

Authors

Yan-Zhong Han^{1

2}, Yu-Ming Guo², Peng Xiong², Fei-Lin Ge², Jing Jing², Ming Niu², Xu Zhao², Zhao-Fang Bai², Hai-Bo Song³, Xiao-He Xiao², Jia-Bo Wang^{2

4}

Affiliations

¹ College of Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu, China.
² China Military Institute of Chinese Medicine, Fifth Medical Center of Chinese People's Liberation Army (PLA) General Hospital, Beijing, China.
³ National Center for Adverse Drug Reaction Monitoring, Beijing, China.
⁴ School of Traditional Chinese Medicine, Capital Medical University, Beijing, China.

Abstract

Objective: Aging population is generally considered more sensitive to adverse drug reactions (ADRs). Yet, big data-based quantitative evidence currently does not exist to support this concept. This study aims to investigate age-associated risks of liver-related ADR (L-ADR).

Methods: Spontaneous reporting data from 2012 to 2016 were retrieved from the China National ADR Monitoring System. The risk ratio (RR) was used to quantify the relative risk of L-ADR of each age group. The reporting odds ratio (ROR) was used to quantify the correlation with the risk of L-ADR of each drug category or drug in older adults.

Results: Totally, 64,702 L-ADR reports were retrieved, covering ages from 1 to 116, with a median age of 49. The RR values increased exponentially with the increase of age, which indicates that the relative risk of L-ADR increased by 33% for every 10-year increase in age. The age cutoff point for relative high risk of L-ADR was estimated at 52.0 years old (RR = 1). In 17 categories composed of 270 drugs, the top 3 drug categories with a high correlation to the risk of L-ADR in older adults were antiarrhythmic (ROR, 5.75; 95% CI: 4.45-7.42), antilipemic (ROR, 4.77; 95% CI: 4.53-5.02), and antihypertensive (ROR, 2.97; 95% CI: 2.59-3.41).

Conclusions: This research illustrates quantitatively that aging is a potential risk factor for L-ADR, with a 33% increase in relative risk for every 10-year increase in age. Risk management should be addressed for older adults when those drugs with a high correlation to the risk of L-ADR are used.

Keywords: adverse drug reaction; hepatotoxicity; older adults; pharmacovigilance; relative risk.