Abstract
The objective of this study was to analyse reports on adverse drug reactions (ADRs) from Germany in the particularly vulnerable patient group of children and adolescents. Reporting characteristics, demographic parameters and off-label use were examined among others. The ratio of ADR reports per number of German inhabitants and the ratio of ADR reports per number of German inhabitants exposed to drugs were calculated and compared. These parameters were examined to derive trends in reporting of ADRs. 20,854 spontaneous ADR reports for the age group 0–17 years were identified in the European ADR database EudraVigilance for the time period 01.01.2000–28.02.2019 and analysed with regard to the aforementioned criteria. 86.5% (18,036/20,854) of the ADR reports originated from Healthcare Professionals and 12.2% (2,546/20,854) from non-Healthcare Professionals. 74.4% (15,522/20,854) of the ADR reports were classified as serious. The proportion of ADR reports per age group was 11.8% (0–1 month), 11.0% (2 months—1 year), 7.4% (2–3 years), 9.3% (4–6 years), 25.8% (7–12 years), and 34.8% (13–17 years) years, respectively. Male sex slightly dominated (51.2% vs. 44.8% females). Only 3.5% of the ADR reports reported off-label use. The annual number of ADR reports increased since 2000, even if set in context with the number of inhabitants and assumed drug-exposed inhabitants. The pediatric population declined in the study period which argues against its prominent role for the increase in the total number of ADR reports. Instead, among others, changes in reporting obligations may apply. The high proportion of serious ADR reports underlines the importance of pediatric drug safety.
Highlights
Adverse drug reactions (ADRs) in children negatively impact on their quality of life, no specific instrument is available to measure the negative effect [1].In Germany, 1.7% of children taking medication on an outpatient basis experience at least one ADR [2]
The identified 20,854 ADR reports were reported by 23,612 reporting sources
12.2% were explicitly reported by a non-Healthcare Professional (HCP) (Table 1)
Summary
Adverse drug reactions (ADRs) in children negatively impact on their quality of life, no specific instrument is available to measure the negative effect [1]. In Germany, 1.7% of children taking medication on an outpatient basis experience at least one ADR [2]. According to systematic reviews the incidence of ADRs leading to hospital admission for children ranges from 0.4% to 10.3% (pooled estimate of 2.9% (2.6%, 3.1%)) [3]. For Germany, the respective figure was 1% [4]. The ADR incidence in hospitalized children is estimated to be higher ranging from 9.53% [5] to 13.1% [6]. In comparison the incidence of hospitalisation of adult outpatients in Germany is 3.2% [7]
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