A data-driven pipeline to extract potential adverse drug reactions through prescription, procedures and medical diagnoses analysis: application to a cohort study of 2,010 patients taking hydroxychloroquine with an 11-year follow-up

• Published in: BMC medical research methodology 2022-06, Vol.22 (1), p.166-166, Article 166
• Main Authors: Sabatier, P, Wack, M, Pouchot, J, Danchin, N, Jannot, A S
• Format: Article
• Language: English
• Subjects: Adverse and side effects; Adverse drug reactions; Bias; Cohort analysis; Complications and side effects; Confidence intervals; Data mining; Drug dosages; Drugs; Electronic health records; Hydroxychloroquine; Life Sciences; Massive data; Medical diagnosis; Medical records; Medical research; Medicine, Experimental; Medico-administrative databases; Methods; Patients; Pharmacovigilance; Prescription drugs; Product safety; Reimbursement; Statistics
• ISSN: 1471-2288; 1471-2288
• DOI: 10.1186/s12874-022-01628-3

Real-life data consist of exhaustive data which are not subject to selection bias. These data enable to study drug-safety profiles but are underused because of their temporality, necessitating complex models (i.e., safety depends on the dose, timing, and duration of treatment). We aimed to create a data-driven pipeline strategy that manages the complex temporality of real-life data to highlight the safety profile of a given drug. We proposed to apply the weighted cumulative exposure (WCE) statistical model to all health events occurring after a drug introduction (in this paper HCQ) and performed bootstrap to select relevant diagnoses, drugs and interventions which could reflect an adverse drug reactions (ADRs). We applied this data-driven pipeline on a French national medico-administrative database to extract the safety profile of hydroxychloroquine (HCQ) from a cohort of 2,010 patients. The proposed method selected eight drugs (metopimazine, anethole trithione, tropicamide, alendronic acid & colecalciferol, hydrocortisone, chlormadinone, valsartan and tixocortol), twelve procedures (six ophthalmic procedures, two dental procedures, two skin lesions procedures and osteodensitometry procedure) and two medical diagnoses (systemic lupus erythematous, unspecified and discoid lupus erythematous) to be significantly associated with HCQ exposure. We provide a method extracting the broad spectrum of diagnoses, drugs and interventions associated to any given drug, potentially highlighting ADRs. Applied to hydroxychloroquine, this method extracted among others already known ADRs.