처방 순서 대칭성 분석을 활용한 국내 환자에서의 글루카곤 유사 펩타이드-1 수용체 작용제 계열 비만치료제 이상사례 분석

초록

agonists for obesity and selected adverse events in South Korea using Prescription Sequence Symmetry Analysis (PSSA). Methods: Prescription data from the Hubase Pharmacy Chain Network were used. New users of GLP-1 receptor agonists were defined as patients who received at least one prescription during the study period (liraglutide: 18.03.01–25.09.27; semaglutide: 24.10.01–25.09.27) with no prescription history of the corresponding drug during the 1-year washout period. Psychiatric and gastrointestinal adverse events were identified using marker medications. PSSA was performed to examine the relationship between initiation of GLP-1 receptor agonists and subsequent marker medication prescriptions by calculating adjusted sequence ratios (aSRs). Results: In the analysis of liraglutide and psychiatric marker medications, the aSR was 0.82 (95% CI: 0.52–1.29), showing no asymmetry in prescription sequences. For semaglutide, the aSR for psychiatric marker medications was 1.32 (95% CI: 0.81–2.13), suggesting a tendency toward increased prescribing after treatment initiation, although this was not statistically significant and was based on a limited number of prescription pairs. In analyses involving gastrointestinal marker medications, the aSRs were 0.65 (95% CI: 0.52–0.81) for liraglutide and 0.87 (95% CI: 0.69–1.10) for semaglutide, with no signals indicating an increased occurrence of gastrointestinal adverse events. Conclusion: No clear prescription sequence asymmetry signals were identified for psychiatric and gastrointestinal adverse events. This study highlights the utility of pharmacy dispensing data for drug safety signal detection in real-world data, while further research with longer observation periods and larger samples is warranted

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