• 약학회지
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• 제50권3호
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• pp.145-153
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• 2006

The adverse events which do not appear in the approval process tend to occur more frequently at the early stage of the use. Therefore new drugs, drugs with different active substances or routes of administration, or drugs with explicitly different efficacy added are particularly chosen for re-examination, and go through a study, which is conducted on 600 to 3,000 subjects over 4 to 6 years. Since the re-examination system was implemented in January 1995, 880 drug products have been designated as the subject of re-examination and among them 194 drugs have been completed their re-examination as of until March 2005. Post Marketing Surveillance to insure drug safety should be correlated with re-examination of new drug, re-evaluation of drug, and adverse event monitoring system. And the first labeling change should reflect all information collected for a defined period of time after the marketing authorization is granted. Furthermore centralized management through spontaneous reporting system of adverse event for whole period of time would be the most desirable type of system.

• 대한의용생체공학회:의공학회지
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• 제43권4호
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• pp.199-213
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• 2022

EN ISO 14971:2012 a risk management standard approved and applied as a European standard in 2012, will be adopted and applied as ISO 14971:2019 published in December 2019, ISO/TR 24971(Guidance) published in June 2020 from May 2022. After that, it is applied to IVDD surveillance and IVDR new and conversion, and the manufacturer is already preparing for application or is starting preparation for application. In addition, 98/78/EEC IVDD applied from 1998 will also be applied as REGULATION (EU) 2017/746 IVDR from May 2022. In particular, in IVDR, the requirements for post-marketing investigations such as Post Market Surveillance (PMS), Summary of safety and performance(SSP), Periodic Safety Update Report(PSUR) and Post Market Performance Follow Up(PMPF), which were not required in the existing IVDD, increased, and the contents were also specified. This study focused on ISO14971:2019 among these strengthened and newly applied regulations, and tried to present a detailed analysis and application plan of Post Market Surveillance (PMS) required by 2017/746 IVDR.

• Translational and Clinical Pharmacology
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• 제26권3호
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• pp.118-127
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• 2018

The safety and efficacy of fimasartan have been evaluated through post-marketing surveillance in real world clinical practice. The multi-center, prospective, open-label and non-interventional study. A total of 3,945 patients (3,729 patients for safety assessment and 3,473 patients for efficacy assessment) were screened in patients with essential hypertension in 89 study centers from 9 September 2010 through 8 September 2016. Among the total patients, 2,893 patients (77.6%) were administered fimasartan for 24 weeks or longer and were classified as 'patients with long-term follow-up', and the additional safety and efficacy analysis were performed. The improvement was defined as systolic blood pressure (SBP) controlled to ${\leq}140mmHg$ or decreased SBP differences ${\geq}20mmHg$ after treatment or diastolic blood pressure (DBP) controlled to ${\leq}90mmHg$ or decreased DBP differences ${\geq}10mmHg$ after treatment. Adverse drug reactions (ADRs) were reported in 3.8% patients; dizziness, and hypotension were the most frequently reported ADRs in total patients. The results of patients with long-term follow-up were comparable with total patients. The overall improvement rate in all efficacy assessment at the last visit was 87.1% (3,025/3,473 patients). The overall improvement rate of the patients with long-term follow-up was 88.9%. Fimasartan was well tolerated, with no new safety concerns identified and an effective treatment in the real world clinical practice for Korean patients with hypertension.

• Journal of Preventive Medicine and Public Health
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• 제40권4호
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• pp.278-284
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• 2007

Despite extensive researches and pre-market clinical trials, only limited information on the adverse drug reactions (ADRs) of a drug can be collected at the time of market approval from regulatory agency. ADRs constitute a major public health problem. Post-marketing surveillance of drugs is important to detect signals for ADR. In Korea, one of the main methods for monitoring the safety of marketed drugs is spontaneous reporting system of suspected ADRs. Re-examination and re-evaluation system are in force for monitoring safety of new market approval drugs and currently under marketing drugs, respectively. Recently, regional pharmacovigilance centers were designated from Korean Food and Drug Administration for facilitating ADR surveillance. Over recent years, with the development of information technology, there has been an increased interest in establishing data mining system for detecting signals from Health Insurance Review Agency database. The purpose of this paper is to review the current status of Korean ADR surveillance system and suggest the possible solutions for developing active pharmacovigilance system in Korea.

• 한국임상약학회지
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• 제29권4호
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• pp.223-230
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• 2019

Background: Small-molecule tyrosine kinase inhibitors (TKIs) have had major impacts on anticancer therapy by targeting the catalytic activities of dysregulated tyrosine kinases. TKIs have not presented traditional toxicities; however, some serious adverse effects, including hepatotoxicity, have been documented in clinical trials and post-marketing surveillance. Although TKI-induced hepatotoxicity can cause severe clinical complications in patients, the underlying mechanism is still unclear. Methods: Studies on TKI-induced hepatotoxicity were identified by Pubmed search, and relevant articles were reviewed. Results: Immunoallergic reaction, cytochrome P (CYP) 450 polymorphisms, and formation of reactive metabolites are under consideration as mechanisms of TKI-induced hepatotoxicity. Host protein-drug metabolite conjugates are recognized as antigens by class II major histocompatibility complexes and are believed to cause liver injuries. Polymorphisms in CYP, which influences TKI metabolism, can slow TKI metabolism and may induce development of hepatotoxicity. The formation of reactive metabolites during drug metabolism can induce hepatotoxicity by directly causing cytotoxicity, leading to cell dysfunction, and indirect toxicity by mediating secondary immune reactions. Concurrent use of various medications with TKI can also cause hepatotoxicity by affecting drug transporter or enzyme activities. Conclusion: Periodic monitoring of patients taking TKIs and risk/benefit reassessments though post marketing surveillance are necessary to prevent hepatotoxicity.

• Infection and chemotherapy
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• 제50권4호
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• pp.301-310
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• 2018

Backgroud: Influenza vaccination is recommended for adults aged ${\geq}65$ years as they are at high risk of significant morbidity and mortality. This open-label, multicenter, post-marketing surveillance study assessed the safety of the MF59-adjuvanted trivalent inactivated subunit influenza vaccine, which is marketed as $FLUAD^{(R)}$ and $VANTAFLU^{(R)}$, in South Korean subjects aged ${\geq}65$ years. Materials and Methods: Solicited local and systemic adverse events (AEs) were collected from day 1 to 4 of the study. All unsolicited AEs and serious AEs (SAEs) were recorded from day 1 until study termination (day 29). Results: Of the 770 subjects enrolled ($FLUAD^{(R)}$, n = 389; $VANTAFLU^{(R)}$, n = 381), 39% overall experienced any solicited AE. Local AEs were reported by 33% of subjects overall; with the most common events being injection-site pain (30%) and tenderness (27%). Systemic AEs were reported by 19% of subjects overall with the most common events being myalgia (11%) and fatigue (8%). Conclusion: These results show that the MF59-adjuvanted influenza vaccine known as $FLUAD^{(R)}$ or $VANTAFLU^{(R)}$ had acceptable safety profiles in older adults (aged ${\geq}65$ years) in South Korea.

• Pediatric Infection and Vaccine
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• 제15권2호
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• pp.115-120
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• 2008

목 적 : 본 시판 후 조사는 한국인에게 투여한 A형 간염 백신(GlaxoSmithKline Biologicals' $Havrix^{TM}$)의 안전성과 반응원성을 평가하기 위해 한국에서 실시되었다. 방 법 : 6세 미만의 1,122명의 피험자를 포함하는 총 1,188명의 건강한 피험자들이 2005년 4월부터 2006년 1월까지 등록되어 A형 간염 백신 1회를 접종 받았다. 백신 접종 후 4일 동안 명시된 증상 보고와 31일의 추적 기간 동안 명시되거나 되지 않은 증상 보고를 위해 피험자 또는 피험자의 부모에게 증상 기록 카드가 제공되었다. 결 과 : 증상 기록 카드를 돌려준 피험자는 568명이었고, 반면에 620명의 피험자는 증상 기록 카드를 돌려 주지 않았다. 증상 기록 카드를 돌려준 피험자들 중에 9.9%가 국소 증상을 보고하였고, 14.3%가 전신 증상을 보고하였다. 증상 기록 카드를 돌려주지 않은 피험자들 가운데 1.6%가 국소 증상을 보고하였으며 8.4%가 전신 증상을 보고하였다. 이 두 군 사이에는 국소 증상과 전신 증상 보고의 빈도에서는 통계적으로 유의한 차이가 있었다. 명시되지 않은 증상은 13.2%의 피험자에서 최소한 한 번 이상 보고 되었다. 결 론 : A형 간염백신($Havrix^{TM}$) 은 접종 후 내약성과 안전성이 있다고 사료된다. 백신 접종 후 증상 기록 카드를 제공함으로써 신뢰할 수 있는 백신 접종 후 이상 반응의 정보를 알 수 있었다.

• 한국임상약학회지
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• 제15권2호
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• pp.94-99
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• 2005

The aim of this study was to evaluate the safety and efficacy of treatment of mesoglycan. This study was conducted between September 2003 and May 2004. A total of 292 patients with vascular disorders including cerebral infarction were enrolled. The patients were administered with 50-100mg of mesoglycan by an oral route everyday for eight weeks. Subjective physicians' assessments of efficacy had ratings of 'improvement', 'invariability', 'exacerbation' and 'not being able to assess'. An improvement was observed in 241 patients out of 274; 18 patients were rules out. The efficacy rate was influenced statistically significantly by the duration of therapy (p=0.0392) and daily mean drug dose (p<0.0001). The adverse events were reported in 8 patients (9 cases) out of 292 patients: skin/appendages disorders (0.7%), liver/biliary system disorders (0.7%), cardiovascular system disorders (0.7%), neurologic disorders (0.3%). respiratory disorders (0.3%) and gastrointestinal system disorders (0.3%). There showed no serious adverse events. These results indicate that mesoglycan was well tolerated and effective for the prevention of vascular disorders.

• Pediatric Infection and Vaccine
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• 제18권1호
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• pp.68-79
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• 2011

목 적:본 시판 후 조사(NCT00750360)는 2002년부터 국내에서 사용 허가된 정제불활화 3가 분할 인플루엔자 백신의 안전성 및 반응원성을 평가하기 위하여 시행되었다. 방 법:생후 6개월 이상의 소아 및 성인 피험자 총 883명을 대상으로 평가대상 인플루엔자 백신을 1회 접종하였다. 이전에 인플루엔자에 감염되지 않았거나 인플루엔자 백신을 접종하지 않은 만 9세 미만의 소아의 경우에는 1회의 추가접종을 실시 하였다. 411명의 피험자가 일일 기록카드를 사용하여 안정성 정보를 기록하였으며 본 보고서에는 이들 피험자들로부터 수집된 자료가 포함되어 있다. 전신 및 투여부위에서의 명시된 이상반응 및 명시되지 않은 이상반응의 발생률을 기록하였다(백신접종 후 각각 4일 및 21일 동안 추적 관찰하였음). 또한 연구진행기간 전체에 걸쳐서 중대한 유해사례를 추적 관찰하여 기록하였다. 결 과 : 가장 흔하게 관찰된 전신 및 투여부위에서의 명시된 이상반응은 접종부위 통증(만 6세 미만의 소아: 12.6%, 만 6세 이상의 소아: 34.7%), 발열(만 6세 미만: 1.3%) 그리고 근육통(만 6세 이상: 13.9%) 이었다. 등급 3의 명시된 이상반응은 전체 피험자의 4.0% 이하에서 보고되었다. 한국식품의약품 안전청의 기준에 따라 백신과 인과관계가 없는 중대한 유해사례도 기록하였다. 결 론 : 평가대상 백신의 전 연령대에서의 확립된 면역원성 및 우수한 안정성, 반응원성 프로파일과 국내에서의 높은 접종률을 고려할 때, 본 백신을 국가예방접종사업에 포함시켜 모든 연령대에서 계절성 인플루엔자 예방 접종을 증진시키기 위한 후보백신으로 추천할 수 있을 것이다.

• Tuberculosis and Respiratory Diseases
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• 제86권1호
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• pp.33-46
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• 2023

Background: Umeclidinium/vilanterol (UMEC/VI; ANORO ELLIPTA, GSK) is a commonly used dual bronchodilator. This study evaluated the safety and effectiveness of UMEC/VI in Korean patients with chronic obstructive pulmonary disease (COPD) over a 6-year period. Methods: This was an open-label, multicentre, observational, post-marketing surveillance study. A total of 3,375 patients were enrolled consecutively in 52 hospitals, by 53 physicians, between July 2014 and July 2020. Patients who were administered UMEC/VI (fixed-dose 62.5 ㎍/25 ㎍) at least once and were monitored for safety and effectiveness were included in the analysis. Incidence and severity of adverse events (AEs) reported after administrating at least one dose of UMEC/VI were monitored, including unexpected adverse events (UAEs) and adverse drug reactions (ADRs). Effectiveness of UMEC/VI after 24 weeks of administration was also assessed using physician's evaluation (effective, ineffective/no change, worsening, indeterminable) and lung function improvement. Results: Of 3,375 patients, 3,086 were included in the safety assessment group (mean age±standard deviation: 69.76±8.80 years; 85.9% male [n=2,652]; 73.1% aged ≥65 years [n=2,255]). The overall incidence of AEs was 28.8% (n=890), of which 2.2% (n=67) were ADRs. Serious AEs and UAEs were reported in 181 (5.9%) and 665 (21.6%) patients, respectively, and two patients (<0.1%) reported unexpected severe ADR. Of the 903/3,086 patients analysed for effectiveness, most (82.8%, n=748) showed overall disease improvement after UMEC/VI treatment. Conclusion: This study confirmed UMEC/VI administered to Korean patients according to the prescribing information was well-tolerated and can be considered an effective option for COPD treatment.