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Incidence, characteristics, and risk factors of drug-associated muscle adverse reaction: a retrospective real-world study of inpatients

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Abstract

Objective

To analyze the clinical characteristics, incidence, and distribution of drug-associated muscle adverse reactions (DAMAR) in real-world inpatients, to provide valuable references for clinical medication use.

Methods

We conducted an automatic retrospective monitoring of inpatients from May 1, 2022, to April 30, 2023, to collect information on adverse drug reactions (ADR) of patients and conducted subsequent analyses.

Results

Among 102,430 hospitalizations, 1106 cases of DAMARs were identified, yielding an incidence of 1.08%, including 125 cases of rhabdomyolysis at an incidence of 0.12%. Seventy-five percent of the patients experienced muscle adverse reactions within 5 days after taking medication, with a median elevated creatine kinase (CK) value of 420.4 IU/L. Risk factors of DAMAR include age ≥ 65, male sex, obesity, hypertension, hepatic and renal insufficiency, and anemia. No significant correlation was observed between the duration of surgery and CK elevation, while the surgical procedure itself had an impact. The 114 drugs associated were predominantly nervous system drugs, anti-infectives for systemic use, and cardiovascular system drugs, with levofloxacin, pregabalin, and parecoxib being the most frequently associated drugs.

Conclusion

Healthcare professionals should be vigilant with patients exhibiting the identified risk factors. Monitoring creatine kinase and related indices when using myotoxic drugs is crucial to preventing serious adverse reactions, ultimately preserving patients’ quality of life.

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Data availability

The data used to support the findings of this study are available upon reasonable request from the authors.

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Funding

This study was supported by the Key Project of Medical Innovation Project in 2017 (No. 17CXZ010) and “the Project of Monitoring and Evaluation of the Use of Key Clinical Drugs” commissioned by the Chinese Association of Research Hospitals (No. Y2023FH-YWPJ03). The funding body had no role in this study.

Author information

Authors and Affiliations

  1. Chinese PLA Medical School, Beijing, China

    Anqi Zhao, Peng Li & An Fu

  2. Department of Pharmacy, Medical Supplies Center, Chinese PLA General Hospital, Beijing, China

    Anqi Zhao, Daihong Guo, Man Zhu, Ao Gao, Peng Li & An Fu

Authors
  1. Anqi Zhao
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  2. Daihong Guo
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  3. Man Zhu
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  4. Ao Gao
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  5. Peng Li
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  6. An Fu
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Contributions

AZ: conception, design, data collection, analysis of data, drafting, and revision of manuscript. DG: conception, design, interpretation of results, and critical revision of manuscript. MZ and AG: interpretation of results revision of manuscript. PL and AF: revision of manuscript. All authors reviewed the manuscript.

Corresponding author

Correspondence to Daihong Guo.

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Ethical approval

The study was approved by the Medical Ethics Committee of PLA General Hospital (No. S2018-54-01). This consent protocol was reviewed, and the need for written and informed consent was waived by the Medical Ethics Committee of PLA General Hospital. All patient data were kept strictly confidential.

Conflict of interest

The authors declare no competing interests.

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Zhao, A., Guo, D., Zhu, M. et al. Incidence, characteristics, and risk factors of drug-associated muscle adverse reaction: a retrospective real-world study of inpatients. Eur J Clin Pharmacol 80, 911–918 (2024). https://doi.org/10.1007/s00228-024-03662-0

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  • DOI: https://doi.org/10.1007/s00228-024-03662-0

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