Published: 5 December 2024
Publications
MARC’s remarks: September 2024 meeting
Prescriber Update 45(4): 91
December 2024
The Medicines Adverse Reaction Committee (MARC) convened for their 199th meeting on 12 September 2024.
The Committee discussed the blood monitoring requirements of clozapine to manage the risk of clozapine-induced neutropenia and agranulocytosis. The Committee commented on difficulties the blood monitoring can cause, and wondered if they are a barrier to clozapine use. The Committee agreed that further expert advice was needed before proposing any changes to monitoring.
The Committee reviewed the recent study by Meng et al,1 showing an association between benzodiazepines and the risk of miscarriage. They considered the findings from this study to be sufficient to require action. The Committee recommended updates to the relevant data sheets to include information on the risk of miscarriage when used in pregnancy and to communicate risks to women who are planning pregnancy.
The Committee discussed the risk of pyoderma gangrenosum (PG) from anti-CD20 antibodies (rituximab, obinutuzumab, ocrelizumab and ofatumumab). They considered that the current evidence of an association between anti-C20 antibodies and PG is weak given the small number of cases reported and confounding by underlying autoimmune disease. The Committee recommended that Medsafe issue a monitoring communication to gather more information on a possible association.
Medsafe presented a summary of New Zealand case reports of ketoacidosis with empagliflozin. The Committee noted Medsafe’s ongoing efforts to raise awareness of this adverse reaction. See also the article about risk factors for ketoacidosis with SGLT-2 inhibitors in this edition of Prescriber Update.
See the Medsafe website for the MARC meeting minutes and the reports presented to the MARC.
Reference
- Meng L-C, Lin C-W, Chuang H-M, et al. 2024. Benzodiazepine use during pregnancy and risk of miscarriage. JAMA Psychiatry 81(4): 366–73. DOI: 10.1001/jamapsychiatry.2023.4912.
