【原著】某醫學中心因藥物相關橫紋肌溶解症或肌肉病變並引起肌肉疼痛之危險因子分析 Analysis the Risk Factors of Drug- Associated Rhabdomyolysis or Myopathy Which Cause Muscle Pain in Medical Center
Objective: A retrospective study of adverse events of drug-associated rhabdomyolysis or myopathy cases reported to medical center was conducted. The analysis included the number of unique cases and the risk factors of adverse events which provide the foundation of clinical medicine use to avoid this adverse events and maintain medication safety. Methods: This study was conducted using administrative claims data including inpatients, outpatients and emergent patients in the medical center between 2009 and 2013. This study screened the study population on the basis of the current consensus definition of rhabdomyolysis or myopathy. The inclusion criterias were: (a) A diagnosis code ICD-9-CM was used to screen rhabdomyolysis or myopathy cases reported. (b) Creatine kinase ≥ 500 IU/L or myoglobulin over normal range. The main outcome measure of this study were the percentage of frequently reported suspected drugs, risk factors and time to onset of adverse events from beginning of the suspected drugs. Results: Drug- associated rhabdomyolysis or myopathy were a total of 186 people in 2009 ~ 2013. HMG-CoA reductase inhibitors which were accounted for the largest, followed by telbivudine , and ranked third daptomycin and fibrates. The time of 25 percentile to significant increase of creatine kinase or myoglobulin was 49 days in survival analysis. Conclusion: It is recommended that routine monitoring of creatine kinase or myoglobulin to avoid the risk of rhabdomyolys or myopathy when the clinical use of HMG-CoA reductase inhibitors, telbivudine , daptomycin and fibrates.