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Pharmacovigilance: methods, recent developments and future perspectives

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Abstract

Background

Pharmacovigilance, defined by the World Health Organisation as ‘the science and activities relating to the detection, assessment, understanding and prevention of adverse effects or any other drug-related problem’ plays a key role in ensuring that patients receive safe drugs. Our knowledge of a drug’s adverse reactions can be increased by various means, including spontaneous reporting, intensive monitoring and database studies. New processes, both at a regulatory and a scientific level, are being developed with the aim of strengthening pharmacovigilance. On a regulatory level, these include conditional approval and risk management plans; on a scientific level, transparency and increased patient involvement are two important elements.

Objective

To review and discuss various aspects of pharmacovigilance, including new methodolgical developments.

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References

  1. World Health Organisation Collaborating Centre for International Drug Monitoring (2007) The importance of pharmacovigilance. Available at http://www.who-umc.org. Cited 18 Dec 2007

  2. Bresalier RS, Sandler RS, Quan H et al. (2005) Cardiovascular events associated with rofecoxib in a colorectal adenoma chemoprevention trial. N Engl J Med 352:1092–1102

    Article  PubMed  CAS  Google Scholar 

  3. Topol EJ (2004) Failing the public health–rofecoxib, Merck, and the FDA. N Engl J Med 351:1707–1079

    Article  PubMed  CAS  Google Scholar 

  4. Horton R (2004) Vioxx, the implosion of Merck, and aftershocks at the FDA. Lancet 364:1995–1996

    Article  PubMed  Google Scholar 

  5. Hampton T (2005) Experts point to lessons learned from controversy over rofecoxib safety. JAMA 293:413–414

    Article  PubMed  CAS  Google Scholar 

  6. Krumholz HM, Ross JS, Presler AH et al. (2007) What have we learnt from Vioxx? Br Med J 334:120–123

    Article  Google Scholar 

  7. Nissen SE, Wolski K (2007) Effect of rosiglitazone on the risk of myocardial infarction and death from cardiovascular causes. N Engl J Med 356:2457–2471

    Article  PubMed  CAS  Google Scholar 

  8. Solomon DH, Winkelmayer WC (2007) Cardiovascular risk and the thiazolidinediones: deja vu all over again? JAMA 298:1216–1218

    Article  PubMed  CAS  Google Scholar 

  9. Hampton T (2007) MI risks linked to rosiglitazone. JAMA 298:1149–1151

    Article  PubMed  CAS  Google Scholar 

  10. Rosen CJ (2007) The rosiglitazone story–lessons from an FDA Advisory Committee meeting. N Engl J Med 357:844–846

    Article  PubMed  CAS  Google Scholar 

  11. Krall RL (2007) Cardiovascular safety of rosiglitazone. Lancet 369:1995–1996

    Article  PubMed  Google Scholar 

  12. Singh S, Loke YK, Furberg CD (2007) Long-term risk of cardiovascular events with rosiglitazone: a meta-analysis. JAMA 298:1189–1195

    Article  PubMed  CAS  Google Scholar 

  13. Home PD, Pocock SJ, Beck-Nielsen H et al (2007) Rosiglitazone evaluated for cardiovascular outcomes–an interim analysis. N Engl J Med 357:28–38

    Article  PubMed  CAS  Google Scholar 

  14. European Medicines Agency (EMEA) (2007) European Medicines Agency confirms positive benefit–risk balance for rosiglitazone and pioglitazone. Available at http://www.emea.europa.eu/pdfs/human/press/pr/48427707en.pdf. Cited 18 Oct 2007

  15. Information for healthcare professionals rosiglitazone maleate (marketed as Avandia, Avandamet, and Avandaryl). Available at http://www.fda.gov/cder/drug/InfoSheets/HCP/rosiglitazone200707HCP.htm. Cited 19 Nov 2007

  16. Mangano DT, Tudor IC, Dietzel C (2006) The risk associated with aprotinin in cardiac surgery. N Engl J Med 354:353–365

    Article  PubMed  CAS  Google Scholar 

  17. European Medicines Agency (EMEA) (2007) European Medicines Agency recommends suspension for marketing authorisation of aprotinin-containing medicines for systemic use. Available at http://www.emea.europa.eu/pdfs/human/press/pr/53467807en.pdf. Cited 1 Feb 2008

  18. Mitka M (2006) Report criticizes lack of FDA oversight. JAMA 296:920–922

    Article  PubMed  CAS  Google Scholar 

  19. Lenzer J (2004) FDA is incapable of protecting US “against another Vioxx”. Br Med J 329:1253

    Article  Google Scholar 

  20. Ray WA, Stein CM (2006) Reform of drug regulation—beyond an independent drug-safety board. N Engl J Med 354:194–201

    Article  PubMed  CAS  Google Scholar 

  21. Furberg CD, Levin AA, Gross PA et al. (2006) The FDA and drug safety: a proposal for sweeping changes. Arch Intern Med 166:1938–1942

    Article  PubMed  Google Scholar 

  22. Avorn J (2007) Paying for drug approvals—who’s using whom? N Engl J Med 356:1697–1700

    Article  PubMed  CAS  Google Scholar 

  23. Strom BL (2006) How the US drug safety system should be changed. JAMA 295:2072–2075

    Article  PubMed  CAS  Google Scholar 

  24. Psaty BM, Charo RA (2007) FDA responds to institute of medicine drug safety recommendations—in part. JAMA 297:1917–1920

    Article  PubMed  CAS  Google Scholar 

  25. Baciu A, Stratton K, and Burke SP (eds) (2006) Committee on the Assessment of the US Drug Safety System The future of drug safety: promoting and protecting the health of the public. Institute of Medicine, Washington D.C.

  26. Psaty BM, Burke SP (2006) Protecting the health of the public–Institute of Medicine recommendations on drug safety. N Engl J Med 355:1753–1755

    Article  PubMed  CAS  Google Scholar 

  27. European Medicines Agency (EMEA) (2006) Assessment of the European Community system of pharmacovigilance. Available at http://www.cbg-meb.nl/NL/docs/nieuws/rapp-fraunhofer.pdf. Cited 18 Dec 2007

  28. Raine JM (2007) Risk management—a European regulatory view. In: Mann R, Andrews E (eds) Pharmacovigilance, 2nd edn. Wiley, Chichester

    Google Scholar 

  29. Gross CP, Mallory R, Heiat A et al. (2002) Reporting the recruitment process in clinical trials: who are these patients and how did they get there? Ann Intern Med 137:10–16

    PubMed  Google Scholar 

  30. Heiat A, Gross CP, Krumholz HM (2002) Representation of the elderly, women, and minorities in heart failure clinical trials. Arch Intern Med 162:1682–1688

    Article  PubMed  Google Scholar 

  31. Zarin DA, Young JL, West JC (2005) Challenges to evidence-based medicine: a comparison of patients and treatments in randomized controlled trials with patients and treatments in a practice research network. Soc Psychiatry Psychiatr Epidemiol 40:27–35

    Article  PubMed  Google Scholar 

  32. Wardell WM, Tsianco MC, Anavekar SN et al. (1979) Postmarketing surveillance of new drugs: I. Review of objectives and methodology. J Clin Pharmacol 19:85–94

    PubMed  CAS  Google Scholar 

  33. McBride WG (1961) Thalidomide and congenital malformations. Lancet 2:1358

    Article  Google Scholar 

  34. van Grootheest K, Olsson S, Couper M et al. (2004) Pharmacists’ role in reporting adverse drug reactions in an international perspective. Pharmacoepidemiol Drug Saf 13:457–464

    Article  PubMed  Google Scholar 

  35. van Grootheest K, de Jong-van den Berg (2004) Patients’ role in reporting adverse drug reactions. Expert Opin Drug Saf 3:363–368

    Article  PubMed  Google Scholar 

  36. van Grootheest AC, Passier JL, van Puijenbroek EP (2005) Direct reporting of side effects by the patient: favourable experience in the first year. Ned Tijdschr Geneeskd 149:529–533

    PubMed  Google Scholar 

  37. Eland IA, Belton KJ, van Grootheest AC et al. (1999) Attitudinal survey of voluntary reporting of adverse drug reactions. Br J Clin Pharmacol 48:623–627

    Article  PubMed  CAS  Google Scholar 

  38. Hazell L, Shakir SA (2006) Under-reporting of adverse drug reactions: a systematic review. Drug Saf 29:385–396

    Article  PubMed  Google Scholar 

  39. Edwards IR (1999) Spontaneous reporting—of what? Clinical concerns about drugs. Br J Clin Pharmacol 48:138–141

    Article  PubMed  CAS  Google Scholar 

  40. Clarke A, Deeks JJ, Shakir SA (2006) An assessment of the publicly disseminated evidence of safety used in decisions to withdraw medicinal products from the UK and US markets. Drug Saf 29:175–181

    Article  PubMed  Google Scholar 

  41. Hauben M, Madigan D, Gerrits CM et al. (2005) The role of data mining in pharmacovigilance. Expert Opin Drug Saf 4:929–948

    Article  PubMed  CAS  Google Scholar 

  42. van Puijenbroek E, Diemont W, van Grooteest K (2003) Application of quantitative signal detection in the Dutch spontaneous reporting system for adverse drug reactions. Drug Saf 26:293–301

    Article  PubMed  Google Scholar 

  43. Bate A, Lindquist M, Edwards IR et al. (2002) A data mining approach for signal detection and analysis. Drug Saf 25:393–397

    Article  PubMed  CAS  Google Scholar 

  44. Szarfman A, Machado SG, O’Neill RT (2002) Use of screening algorithms and computer systems to efficiently signal higher-than-expected combinations of drugs and events in the US FDA’s spontaneous reports database. Drug Saf 25:381–392

    Article  PubMed  CAS  Google Scholar 

  45. Mackay FJ (1998) Post-marketing studies: the work of the Drug Safety Research Unit. Drug Saf 19:343–353

    Article  PubMed  CAS  Google Scholar 

  46. Mann RD (1998) Prescription-event monitoring–recent progress and future horizons. Br J Clin Pharmacol 46:195–201

    Article  PubMed  CAS  Google Scholar 

  47. Coulter DM (1998) The New Zealand Intensive Medicines Monitoring Programme. Pharmacoepidemiol Drug Saf 7:79–90

    Article  PubMed  CAS  Google Scholar 

  48. Coulter DM (2000) The New Zealand Intensive Medicines Monitoring Programme in pro-active safety surveillance. Pharmacoepidemiol Drug Saf 9:273–280

    Article  Google Scholar 

  49. Shakir SAW (2007) PEM in the UK. In: Mann R, Andrews E (eds) Pharmacovigilance, 2nd edn. Wiley, Chichester

    Google Scholar 

  50. European Commission Enterprise and Industry Directorate-general (2007) Strategy to better protect public health by strengthening and rationalising EU pharmacovigilance. European Commission Enterprise and Industry, Brussels

  51. Strom BL, (Ed) (2005). Pharmacoepidemiology, 4th edn. Wiley, Chichester

  52. Gelfand JM, Margolis DJ, Dattani H (2005) The UK general practice research database. In: Strom BL (ed) Pharmacoepidemiology, 4th edn. Wiley, Chichester

    Google Scholar 

  53. Parkinson J, Davies S, Van Staa T (2007) The general practice research database: now and the future. In: Mann R, Andrews E (eds) Pharmacovigilance, 2nd edn. Wiley, Chichester

    Google Scholar 

  54. Wood L, Martinez C (2004) The general practice research database: role in pharmacovigilance. Drug Saf 27:871–881

    Article  PubMed  Google Scholar 

  55. Leufkens HG, Urquhart J (2005) Automated pharmacy record linkage in the Netherlands. In: Strom BL (ed) Pharmacoepidemiology. 4th edn. Wiley, Chichester

    Google Scholar 

  56. Sturkenboom MCJM (2007) Other databases in Europe for the analytic evaluation of drug effects. In: Mann R, Andrews E (eds) Pharmacovigilance, 2nd edn. Wiley, Chichester

    Google Scholar 

  57. Hugman B (2006) The Erice declaration: the critical role of communication in drug safety. Drug Saf 29:91–93

    Article  PubMed  Google Scholar 

  58. Adis International (2007) The Erice Manifesto: for global reform of the safety of medicines in patient care. Drug Saf 30:187–190

    Google Scholar 

  59. Waller PC, Evans SJ (2003) A model for the future conduct of pharmacovigilance. Pharmacoepidemiol Drug Saf 12:17–29

    Article  PubMed  Google Scholar 

  60. European Medicines Agency (EMEA) (2007) European risk management strategy: achievements to date. Available at http://www.emea.europa.eu/pdfs/human/phv/30816707en.pdf. Cited 18 Dec 2007

  61. European Medicines Agency (EMEA) (2007) Public status report on the implementation of the European risk management strategy. Available at http://www.emea.europa.eu/pdfs/human/phv/16895407en.pdf. Cited 18 Dec 2007

  62. McClellan M (2007) Drug safety reform at the FDA–pendulum swing or systematic improvement? N Engl J Med 356:1700–1702

    Article  PubMed  CAS  Google Scholar 

  63. Coombes R (2007) FDA tightens its grip on drug regulation. Br Med J 334:290–291

    Article  Google Scholar 

  64. Zwillich T (2007) US lawmakers tackle safety reforms at the FDA. Lancet 369:1989–90

    Article  PubMed  Google Scholar 

  65. Hennessy S, Strom BL (2007) PDUFA reauthorization—drug safety’s golden moment of opportunity? N Engl J Med 356:1703–1704

    Article  PubMed  CAS  Google Scholar 

  66. Sim I, Chan AW, Gulmezoglu AM et al. (2006) Clinical trial registration: transparency is the watchword. Lancet 367:1631–1633

    Article  PubMed  Google Scholar 

  67. European Medicines Agency (EMEA) (2005) Guideline on procedures for the granting of a marketing authorization under exceptional circumstances, pursuant to article 14(8) of regulation (EC) NO 726/2004 Available at http://www.emea.europa.eu/pdfs/human/euleg/35798105en.pdf. Cited 18 Dec 2007

  68. European Medicines Agency (EMEA) (2005) Guideline on risk management systems for medicinal products for human use. Available at http://www.emea.europa.eu/pdfs/human/euleg/9626805en.pdf. Cited 18 Dec 2007

  69. van Grootheest K, de Graaf L, de Jong-van den Berg LT (2003) Consumer adverse drug reaction reporting: a new step in pharmacovigilance? Drug Saf 26:211–217

    Article  PubMed  Google Scholar 

  70. de Langen J, van Hunsel F, Passier A, de Jong-van den Berg L, van Grootheest K (2008) Adverse drug reaction reporting by patients in the Netherlands: Three years of experience. Drug Saf 6:515–524

    Article  Google Scholar 

  71. Härmark L, Kabel JS, van Puijenbroek EP, van Grootheest AC (2006) Web-based intensive monitoring, a new patient based tool for early signal detection (abstr). Drug Saf 29:911–1010

    Article  Google Scholar 

  72. Pirmohamed M, Park BK (2001) Genetic susceptibility to adverse drug reactions. Trends Pharmacol Sci 22:298–305

    Article  PubMed  CAS  Google Scholar 

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Härmark, L., van Grootheest, A.C. Pharmacovigilance: methods, recent developments and future perspectives. Eur J Clin Pharmacol 64, 743–752 (2008). https://doi.org/10.1007/s00228-008-0475-9

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  • DOI: https://doi.org/10.1007/s00228-008-0475-9

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