Drug-Associated Parosmia: New Perspectives from the WHO Safety Database

Abstract

Parosmia is a qualitative distortion of smell perception. Resulting from central causes, sinonasal diseases, and infections, parosmia has also been associated with medications. Therefore, we aimed to investigate potential signals for drugs associated with parosmia. VigiBase® (the WHO pharmacovigilance database) was queried for all reports of “Parosmia” (MedDRA Preferred Term), registered up to 23 January 2022. Disproportionality analysis relied on the reporting odds ratio and the information component. A signal is detected when the lower end of the 95% confidence interval of the information component is positive. We found 14,032 reports of parosmia, with a median patient age of 53 years. Most reported drugs were antiinfectives, among which COVID-19 vaccines accounted for 27.1% of reports. Antibiotics and corticosteroids were involved in 6.8% and 4.6% of reports. Significant disproportionate reporting was detected for corticosteroids, antibiotics, drugs used in nicotine dependence, COVID-19 and HPV vaccines, serotonin–norepinephrine reuptake inhibitors (SNRI), and incretin mimetics. We suggest potential safety signals involving nicotine replacement therapies and vaccines. We also highlight the potential role of less suspected classes, such as SNRIs and incretin mimetics. An iatrogenic etiology should be evoked when parosmia occurs, especially in the elderly.

Adverse Events of GLP-1 Receptor Agonists for Weight Loss: Twitter and a National Pharmacovigilance Database

“…These adverse events were not reported in clinical trials for approval (Pi-Sunyer et al 2015), but were observed in four year of post-marketing surveillance (Ministry of Food and Drug Safety 2022). In particular, parosmia is a rare adverse event that only 30 cases of liraglutide have been reported in the international pharmacovigilance database of the World Health Organization (Merino et al 2022). The adverse events observed in post-marketing surveillance were identified on Twitter, indicating the usefulness of pharmacovigilance using Twitter.…”