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Erschienen in: Journal of General Internal Medicine 6/2011

01.06.2011 | Original Research

Different Black Box Warning Labeling for Same-Class Drugs

verfasst von: Orestis A. Panagiotou, MD, Despina G. Contopoulos-Ioannidis, MD, Panagiotis N. Papanikolaou, MD, Evangelia E. Ntzani, MD, John P. A. Ioannidis, MD, DSc

Erschienen in: Journal of General Internal Medicine | Ausgabe 6/2011

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ABSTRACT

INTRODUCTION

Black box warnings (BBWs) are the strongest medication-related safety warnings in a drug’s labeling information and highlight major risks. Absence of a BBW or asynchronous addition of a BBW among same-class drugs could have major implications.

METHODS

We identified the 20 top-selling drugs in 2008 (10 with BBWs and 10 without BBWs on their label) that belonged to different drug classes. We collected labeling information on all drugs belonging in these 20 classes, and recorded differences in the presence and timing of acquisition of BBWs for same-class drugs.

RESULTS

Across the 20 evaluated drug classes, we identified 176 different agents, of which 7 had been withdrawn for safety reasons. The reasons for the withdrawals became BBWs in other same-class agents only in two of the seven cases. Differences were identified in 9 of the 20 classes corresponding to 15 BBWs that were not present in all drugs of the same class. The information for 10 of the 15 different BBWs were included in the labels of same-class drugs as simple warnings or text, while it was absent entirely in 5 BBWs. The median interval from the time the BBW had appeared in another drug of the same class was 66 months.

DISCUSSION

Differences in BBW labeling in same-class drugs are common and shape impressions about the safety of similar agents. BBW labeling needs to become more systematic.
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Literatur
1.
Zurück zum Zitat Lazarou J, Pomeranz BH, Corey PN. Incidence of adverse drug reactions in hospitalized patients: a meta-analysis of prospective studies. JAMA 1998;279:1200–5.PubMedCrossRef Lazarou J, Pomeranz BH, Corey PN. Incidence of adverse drug reactions in hospitalized patients: a meta-analysis of prospective studies. JAMA 1998;279:1200–5.PubMedCrossRef
2.
Zurück zum Zitat Davies EC, Green CF, Taylor S, Williamson PR, Mottram DR, Pirmohamed M. Adverse drug reactions in hospital in-patients: a prospective analysis of 3695 patient-episodes. PLoS One 2009;4:e4439.PubMedCrossRef Davies EC, Green CF, Taylor S, Williamson PR, Mottram DR, Pirmohamed M. Adverse drug reactions in hospital in-patients: a prospective analysis of 3695 patient-episodes. PLoS One 2009;4:e4439.PubMedCrossRef
3.
Zurück zum Zitat Wester K, Jonsson AK, Spigset O, Druid H, Hagg S. Incidence of fatal adverse drug reactions: a population based study. Br J Clin Pharmacol 2008;65:573–9.PubMedCrossRef Wester K, Jonsson AK, Spigset O, Druid H, Hagg S. Incidence of fatal adverse drug reactions: a population based study. Br J Clin Pharmacol 2008;65:573–9.PubMedCrossRef
4.
Zurück zum Zitat Hug BL, Witkowski DJ, Sox CM, et al. Adverse drug event rates in six community hospitals and the potential impact of computerized physician order entry for prevention. J Gen Intern Med 2010;25:31–8.PubMedCrossRef Hug BL, Witkowski DJ, Sox CM, et al. Adverse drug event rates in six community hospitals and the potential impact of computerized physician order entry for prevention. J Gen Intern Med 2010;25:31–8.PubMedCrossRef
5.
Zurück zum Zitat Cheng CM, Guglielmo BJ, Maselli J, Auerbach AD. Coverage of FDA medication boxed warnings in commonly used drug information resources. Arch Intern Med 2010;170:831–3.PubMedCrossRef Cheng CM, Guglielmo BJ, Maselli J, Auerbach AD. Coverage of FDA medication boxed warnings in commonly used drug information resources. Arch Intern Med 2010;170:831–3.PubMedCrossRef
6.
Zurück zum Zitat Marks NS, Weiss K. Boxed warnings and other FDA communication tools. Am Fam Physician 2010;81:259.PubMed Marks NS, Weiss K. Boxed warnings and other FDA communication tools. Am Fam Physician 2010;81:259.PubMed
7.
8.
Zurück zum Zitat Ricci JR, Coulen C, Berger JE, Moore MC, McQueen A, Jan SA. Prescriber compliance with black box warnings in older adult patients. Am J Manag Care 2009;15:e103–8.PubMed Ricci JR, Coulen C, Berger JE, Moore MC, McQueen A, Jan SA. Prescriber compliance with black box warnings in older adult patients. Am J Manag Care 2009;15:e103–8.PubMed
9.
Zurück zum Zitat Wagner AK, Chan KA, Dashevsky I, et al. FDA drug prescribing warnings: is the black box half empty or half full? Pharmacoepidemiol Drug Saf 2006;15:369–86.PubMedCrossRef Wagner AK, Chan KA, Dashevsky I, et al. FDA drug prescribing warnings: is the black box half empty or half full? Pharmacoepidemiol Drug Saf 2006;15:369–86.PubMedCrossRef
11.
Zurück zum Zitat Wysowski DK, Swartz L. Adverse drug event surveillance and drug withdrawals in the United States, 1969–2002: the importance of reporting suspected reactions. Arch Intern Med 2005;165:1363–9.PubMedCrossRef Wysowski DK, Swartz L. Adverse drug event surveillance and drug withdrawals in the United States, 1969–2002: the importance of reporting suspected reactions. Arch Intern Med 2005;165:1363–9.PubMedCrossRef
12.
Zurück zum Zitat Generali JA. The continuing dilemma of drugs with black box warnings. Hospital Pharmacy 2008;43:7.CrossRef Generali JA. The continuing dilemma of drugs with black box warnings. Hospital Pharmacy 2008;43:7.CrossRef
13.
Zurück zum Zitat Lasser KE, Allen PD, Woolhandler SJ, Himmelstein DU, Wolfe SM, Bor DH. Timing of new black box warnings and withdrawals for prescription medications. JAMA 2002;287:2215–20.PubMedCrossRef Lasser KE, Allen PD, Woolhandler SJ, Himmelstein DU, Wolfe SM, Bor DH. Timing of new black box warnings and withdrawals for prescription medications. JAMA 2002;287:2215–20.PubMedCrossRef
14.
Zurück zum Zitat Raber JH. The formulary process from a risk management perspective. Pharmacotherapy 2010;30:42S–7S.PubMedCrossRef Raber JH. The formulary process from a risk management perspective. Pharmacotherapy 2010;30:42S–7S.PubMedCrossRef
15.
Zurück zum Zitat Beach JE, Faich GA, Bormel FG, Sasinowski FJ. Black box warnings in prescription drug labeling: results of a survey of 206 drugs. Food Drug Law J 1998;53:403–11.PubMed Beach JE, Faich GA, Bormel FG, Sasinowski FJ. Black box warnings in prescription drug labeling: results of a survey of 206 drugs. Food Drug Law J 1998;53:403–11.PubMed
16.
18.
Zurück zum Zitat Lasser KE, Seger DL, Yu DT, et al. Adherence to black box warnings for prescription medications in outpatients. Arch Intern Med 2006;166:338–44.PubMedCrossRef Lasser KE, Seger DL, Yu DT, et al. Adherence to black box warnings for prescription medications in outpatients. Arch Intern Med 2006;166:338–44.PubMedCrossRef
19.
Zurück zum Zitat Liang BA. FDA use of the black box warning: time for reevaluation as a safety tool. J Clin Anesth 2002;14:561–3.PubMedCrossRef Liang BA. FDA use of the black box warning: time for reevaluation as a safety tool. J Clin Anesth 2002;14:561–3.PubMedCrossRef
20.
Zurück zum Zitat Habib AS, Gan TJ. Pro: The Food and Drug Administration Black box warning on droperidol is not justified. Anesth Analg 2008;106:1414–7.PubMedCrossRef Habib AS, Gan TJ. Pro: The Food and Drug Administration Black box warning on droperidol is not justified. Anesth Analg 2008;106:1414–7.PubMedCrossRef
21.
Zurück zum Zitat Dorsey ER, Rabbani A, Gallagher SA, Conti RM, Alexander GC. Impact of FDA black box advisory on antipsychotic medication use. Arch Intern Med 2010;170:96–103.PubMedCrossRef Dorsey ER, Rabbani A, Gallagher SA, Conti RM, Alexander GC. Impact of FDA black box advisory on antipsychotic medication use. Arch Intern Med 2010;170:96–103.PubMedCrossRef
22.
Zurück zum Zitat Halloran K, Barash PG. Inside the black box: current policies and concerns with the United States Food and Drug Administration’s highest drug safety warning system. Curr Opin Anaesthesiol 2010;23:423–7.PubMedCrossRef Halloran K, Barash PG. Inside the black box: current policies and concerns with the United States Food and Drug Administration’s highest drug safety warning system. Curr Opin Anaesthesiol 2010;23:423–7.PubMedCrossRef
24.
Zurück zum Zitat PDR® Electronic Library™ 2009, 63rd ed. Greenwood Village, Colorado: Thomson Reuters (Healthcare) Inc. PDR® Electronic Library™ 2009, 63rd ed. Greenwood Village, Colorado: Thomson Reuters (Healthcare) Inc.
36.
Zurück zum Zitat Jacoby JL, Fulton J, Cesta M, Heller M. After the black box warning: dramatic changes in ED use of droperidol. Am J Emerg Med 2005;23:196.PubMedCrossRef Jacoby JL, Fulton J, Cesta M, Heller M. After the black box warning: dramatic changes in ED use of droperidol. Am J Emerg Med 2005;23:196.PubMedCrossRef
37.
Zurück zum Zitat Cheung A, Sacks D, Dewa CS, Pong J, Levitt A. Pediatric prescribing practices and the FDA black-box warning on antidepressants. J Dev Behav Pediatr 2008;29:213–5.PubMedCrossRef Cheung A, Sacks D, Dewa CS, Pong J, Levitt A. Pediatric prescribing practices and the FDA black-box warning on antidepressants. J Dev Behav Pediatr 2008;29:213–5.PubMedCrossRef
38.
Zurück zum Zitat Nemeroff CB, Kalali A, Keller MB, et al. Impact of publicity concerning pediatric suicidality data on physician practice patterns in the United States. Arch Gen Psychiatry 2007;64:466–72.PubMedCrossRef Nemeroff CB, Kalali A, Keller MB, et al. Impact of publicity concerning pediatric suicidality data on physician practice patterns in the United States. Arch Gen Psychiatry 2007;64:466–72.PubMedCrossRef
39.
Zurück zum Zitat Redmond K. The US and European regulatory systems: a comparison. J Ambul Care Manage 2004;27:105–14.PubMed Redmond K. The US and European regulatory systems: a comparison. J Ambul Care Manage 2004;27:105–14.PubMed
40.
Zurück zum Zitat Rawson NS. Time required for approval of new drugs in Canada, Australia, Sweden, the United Kingdom and the United States in 1996–1998. CMAJ 2000;162:501–4.PubMed Rawson NS. Time required for approval of new drugs in Canada, Australia, Sweden, the United Kingdom and the United States in 1996–1998. CMAJ 2000;162:501–4.PubMed
41.
Zurück zum Zitat Platt R, Wilson M, Chan KA, Benner JS, Marchibroda J, McClellan M. The new Sentinel Network—improving the evidence of medical-product safety. N Engl J Med 2009;361:645–7.PubMedCrossRef Platt R, Wilson M, Chan KA, Benner JS, Marchibroda J, McClellan M. The new Sentinel Network—improving the evidence of medical-product safety. N Engl J Med 2009;361:645–7.PubMedCrossRef
42.
Zurück zum Zitat Ioannidis JP, Mulrow CD, Goodman SN. Adverse events: the more you search, the more you find. Ann Intern Med 2006;144:298–300.PubMed Ioannidis JP, Mulrow CD, Goodman SN. Adverse events: the more you search, the more you find. Ann Intern Med 2006;144:298–300.PubMed
43.
Zurück zum Zitat Ioannidis JP, Evans SJ, Gotzsche PC, et al. Better reporting of harms in randomized trials: an extension of the CONSORT statement. Ann Intern Med 2004;141:781–8.PubMed Ioannidis JP, Evans SJ, Gotzsche PC, et al. Better reporting of harms in randomized trials: an extension of the CONSORT statement. Ann Intern Med 2004;141:781–8.PubMed
44.
Zurück zum Zitat Sackett DL, Rosenberg WM, Gray JA, Haynes RB, Richardson WS. Evidence based medicine: what it is and what it isn’t. BMJ 1996;312:71–2.PubMed Sackett DL, Rosenberg WM, Gray JA, Haynes RB, Richardson WS. Evidence based medicine: what it is and what it isn’t. BMJ 1996;312:71–2.PubMed
45.
Zurück zum Zitat Ioannidis JP. Integration of evidence from multiple meta-analyses: a primer on umbrella reviews, treatment networks and multiple treatments meta-analyses. CMAJ 2009;181:488–93.PubMed Ioannidis JP. Integration of evidence from multiple meta-analyses: a primer on umbrella reviews, treatment networks and multiple treatments meta-analyses. CMAJ 2009;181:488–93.PubMed
46.
47.
Zurück zum Zitat Schwartz LM, Woloshin S. Lost in transmission—FDA drug information that never reaches clinicians. N Engl J Med 2009;361:1717–20.PubMedCrossRef Schwartz LM, Woloshin S. Lost in transmission—FDA drug information that never reaches clinicians. N Engl J Med 2009;361:1717–20.PubMedCrossRef
48.
Zurück zum Zitat Cook DM, Gurugubelli RK, Bero LA. Risk management policy and black-box warnings: a qualitative analysis of US FDA proceedings. Drug Saf 2009;32:1057–66.PubMedCrossRef Cook DM, Gurugubelli RK, Bero LA. Risk management policy and black-box warnings: a qualitative analysis of US FDA proceedings. Drug Saf 2009;32:1057–66.PubMedCrossRef
Metadaten
Titel
Different Black Box Warning Labeling for Same-Class Drugs
verfasst von
Orestis A. Panagiotou, MD
Despina G. Contopoulos-Ioannidis, MD
Panagiotis N. Papanikolaou, MD
Evangelia E. Ntzani, MD
John P. A. Ioannidis, MD, DSc
Publikationsdatum
01.06.2011
Verlag
Springer-Verlag
Erschienen in
Journal of General Internal Medicine / Ausgabe 6/2011
Print ISSN: 0884-8734
Elektronische ISSN: 1525-1497
DOI
https://doi.org/10.1007/s11606-011-1633-9

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