Frequent discussion of insomnia and weight gain with glucocorticoid therapy: an analysis of Twitter posts

In recent years, social media websites have been suggested as a novel, vast source of data which may be useful for deriving drug safety information. Despite this, there are few published reports of drug safety profiles derived in this way. The aims of this study were to detect and quantify glucocorticoid-related adverse events using a computerised system for automated detection of suspected adverse drug reactions (ADR) from narrative text in Twitter, and to compare the frequency of specific ADR mentions within Twitter to the frequency and patterns of spontaneous ADR reporting to a national drug regulatory body. Of 159,297 tweets mentioning either prednisolone or prednisone between 1st October 2012 and 30th June 2015, 20,206 tweets were deemed to contain information resembling an ADR. The top AE MedDRA® Preferred Terms were ‘insomnia’ and ‘weight increased’, both recognised non-serious but common side effects. These were proportionally over-reported in Twitter when compared to spontaneous reports in the UK regulator’s ADR reporting scheme. Serious glucocorticoid related AEs were reported less frequently. Pharmacovigilance using Twitter data has the potential to be a valuable, supplementary source of drug safety information. In particular, it can illustrate which drug side effects patients discuss most commonly, potentially because of important impacts on quality of life. This information could help clinicians to inform patients about frequent and relevant non-serious side effects as well as more serious side effects.Social media: Twitter posts track common side effects of steroid therapyPatients on steroid drugs often complain of insomnia and weight gain on Twitter, offering a window into commonly experienced side effects. William Dixon from the University of Manchester, UK, and colleagues searched for mentions of either prednisolone or prednisone on Twitter between October 2012 and June 2015. They documented around 20,000 tweets on the social media platform that contained discussion of an adverse drug reaction. The top side effects cited were “insomnia” and “weight increased”, both of which constituted a larger proportion of total steroid-related complaints on Twitter than in the official UK regulator’s reporting scheme. Serious side effects were mentioned less frequently on Twitter. The findings show the power of social media data to identify the side effects impacting quality of life among patients.

[1]  M. Boers,et al.  Patient and rheumatologist perspectives on glucocorticoids: an exercise to improve the implementation of the European League Against Rheumatism (EULAR) recommendations on the management of systemic glucocorticoid therapy in rheumatic diseases , 2009, Annals of the rheumatic diseases.

[2]  John S. Brownstein,et al.  Erratum to: Digital Drug Safety Surveillance: Monitoring Pharmaceutical Products in Twitter , 2014, Drug Safety.

[3]  J. Jacobs,et al.  The value of glucocorticoid co-therapy in different rheumatic diseases - positive and adverse effects , 2014, Arthritis Research & Therapy.

[4]  L. Hazell,et al.  Under-Reporting of Adverse Drug Reactions , 2006, Drug safety.

[5]  L. Fardet,et al.  Systemic glucocorticoid therapy: risk factors for reported adverse events and beliefs about the drug. A cross-sectional online survey of 820 patients , 2015, Clinical Rheumatology.

[6]  T. Benedek.  History of the development of corticosteroid therapy. , 2011, Clinical and experimental rheumatology.

[7]  Clark C. Freifeld,et al.  Digital pharmacovigilance: The MedWatcher system for monitoring adverse events through automated processing of Internet social media and crowdsourcing , 2014 .

[8]  W. Dixon,et al.  Patient perceptions of glucocorticoid side effects: a cross-sectional survey of users in an online health community , 2017, BMJ Open.

[9]  Graciela Gonzalez-Hernandez,et al.  Utilizing social media data for pharmacovigilance: A review , 2015, J. Biomed. Informatics.

[10]  R. Horne,et al.  The influence of symptom experiences and attributions on adherence to highly active anti-retroviral therapy (HAART): a six-month prospective, follow-up study , 2009, AIDS care.

[11]  H. Capell,et al.  Attitude of rheumatoid arthritis patients to treatment with oral corticosteroids. , 2003, Rheumatology.

[12]  L Abenhaim,et al.  Use of oral corticosteroids in the United Kingdom. , 2000, QJM : monthly journal of the Association of Physicians.

[13]  Benedek Tg.  History of the development of corticosteroid therapy. , 2011 .

[14]  Khusru Asadullah,et al.  Mechanisms involved in the side effects of glucocorticoids. , 2002, Pharmacology & therapeutics.

[15]  Andrew Herxheimer,et al.  Communicating with Patients about Harms and Risks , 2005, PLoS medicine.

[16]  Jeffery L. Painter,et al.  Social Media Listening for Routine Post-Marketing Safety Surveillance , 2016, Drug Safety.

[17]  B. Roehr.  US hospital incident reporting systems do not capture most adverse events , 2012, BMJ : British Medical Journal.

[18]  Abeed Sarker,et al.  Pharmacovigilance from social media: mining adverse drug reaction mentions using sequence labeling with word embedding cluster features , 2015, J. Am. Medical Informatics Assoc..

[19]  E. Russo,et al.  Limitations and obstacles of the spontaneous adverse drugs reactions reporting: Two “challenging” case reports , 2013, Journal of pharmacology & pharmacotherapeutics.

[20]  R. Horne,et al.  Patient-reported side effects, concerns and adherence to corticosteroid treatment for asthma, and comparison with physician estimates of side-effect prevalence: a UK-wide, cross-sectional study , 2015, npj Primary Care Respiratory Medicine.

[21]  R. Horne,et al.  Prediction of nonspecific side effects in rheumatoid arthritis patients by beliefs about medicines , 2010, Arthritis care & research.

[22]  W. Dixon,et al.  Understanding the side effects of glucocorticoid therapy: shining a light on a drug everyone thinks they know , 2012, Annals of the rheumatic diseases.