Evaluation of Drug-Induced Photosensitivity Using the Japanese Adverse Drug Event Report (JADER) Database

Biol Pharm Bull. 2017;40(12):2158-2165. doi: 10.1248/bpb.b17-00561.

Abstract

Drug-induced photosensitivity (DIP) refers to the development of cutaneous disorders caused by the combined effects of different medications and light. The aim of this study was to obtain new information on drug risk comparisons and on DIP onset profiles, including seasonal variations, for clinically used prescription drugs. We analyzed reports of DIP recorded in the Japanese Adverse Drug Event Report (JADER) database using a reporting odds ratio (ROR). We also used Weibull proportional-hazards models for each drug to examine the patterns of DIP. The JADER database contains 430587 reports recorded from April 2004 to November 2016. The ROR values (95% confidence interval [CI]) of losartan/hydrochlorothiazide (HCTZ), valsartan/HCTZ, and ketoprofen were 214.5 (162.1-283.9), 104.7 (66.3-165.5), and 117.9 (76.6-181.5), respectively. For time-to-onset analysis, the median durations (interquartile range) for DIP caused by losartan/HCTZ, valsartan/HCTZ, and ketoprofen were 56 (41-78), 49 (38-88), and 8 (2-14) days, respectively. The lower limit of the 95% CI for the Weibull shape parameter β value for losartan/HCTZ was greater than 1. More than half of the reports of DIP onset following the administration of ketoprofen were recorded within 10 d of treatment initiation. The seasonal variation of photosensitivity reactions was shown to follow an annual sinusoidal pattern with a peak in April and May. Based on the results, losartan/HCTZ, valsartan/HCTZ, and ketoprofen should be used carefully in clinical practice to avoid DIP.

Keywords: Japanese Adverse Drug Event Report database; hydrochlorothiazide; ketoprofen; photosensitivity; seasonal variation.

MeSH terms

  • Adolescent
  • Adult
  • Adverse Drug Reaction Reporting Systems / statistics & numerical data*
  • Aged
  • Aged, 80 and over
  • Angiotensin II Type 1 Receptor Blockers / adverse effects*
  • Anti-Inflammatory Agents, Non-Steroidal / adverse effects*
  • Drug Combinations
  • Female
  • Humans
  • Hydrochlorothiazide / adverse effects
  • Incidence
  • Japan / epidemiology
  • Ketoprofen / adverse effects
  • Losartan / adverse effects
  • Male
  • Middle Aged
  • Odds Ratio
  • Photosensitivity Disorders / chemically induced
  • Photosensitivity Disorders / epidemiology*
  • Seasons
  • Sodium Chloride Symporter Inhibitors / adverse effects*
  • Valsartan / adverse effects
  • Young Adult

Substances

  • Angiotensin II Type 1 Receptor Blockers
  • Anti-Inflammatory Agents, Non-Steroidal
  • Drug Combinations
  • Sodium Chloride Symporter Inhibitors
  • hydrochlorothiazide, losartan drug combination
  • Hydrochlorothiazide
  • Valsartan
  • Ketoprofen
  • Losartan