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Increased Mortality in Groups of Cattle Administered the β-Adrenergic Agonists Ractopamine Hydrochloride and Zilpaterol Hydrochloride

机译:服用β-肾上腺素激动剂盐酸雷克多巴胺和盐酸齐帕特罗的牛群死亡率增加

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摘要

The United States Food and Drug Administration (FDA) approved two β-adrenergic agonists (βAA) for in-feed administration to cattle fed in confinement for human consumption. Anecdotal reports have generated concern that administration of βAA might be associated with an increased incidence of cattle deaths. Our objectives, therefore, were to a) quantify the association between βAA administration and mortality in feedlot cattle, and b) explore those variables that may confound or modify this association. Three datasets were acquired for analysis: one included information from randomized and controlled clinical trials of the βAA ractopamine hydrochloride, while the other two were observational data on zilpaterol hydrochloride administration to large numbers of cattle housed, fed, and cared for using routine commercial production practices in the U.S. Various population and time at-risk models were developed to explore potential βAA relationships with mortality, as well as the extent of confounding and effect modification. Measures of effect were relatively consistent across datasets and models in that the cumulative risk and incidence rate of death was 75 to 90% greater in animals administered the βAA compared to contemporaneous controls. During the exposure period, 40 to 50% of deaths among groups administered the βAA were attributed to administration of the drug. None of the available covariates meaningfully confounded the relationship between βAA and increased mortality. Only month of slaughter, presumably a proxy for climate, consistently modified the effect in that the biological association was generally greatest during the warmer months of the year. While death is a rare event in feedlot cattle, the data reported herein provide compelling evidence that mortality is nevertheless increased in response to administration of FDA-approved βAA and represents a heretofore unquantified adverse drug event.
机译:美国食品药品监督管理局(FDA)批准了两种β-肾上腺素能激动剂(βAA)用于在禁食状态下供人食用的牛的饲料内给药。轶事报道引起了人们的关注,即服用βAA可能与牛死亡的发生率增加有关。因此,我们的目标是:a)量化饲喂牛的βAA与死亡率之间的关联,b)探索可能混淆或改变这种关联的变量。获得了三个数据集进行分析:一个包含来自βAA莱克多巴胺盐酸盐的随机和对照临床试验的信息,而另两个包含有关盐酸齐帕特罗对常规饲养生产,饲养和照料的大量牛的施用的观察性数据在美国,开发了各种人群和高危时间模型,以探索潜在的βAA与死亡率的关系,以及混淆程度和效果改变的程度。在不同的数据集和模型中,效果的衡量标准相对一致,因为与同期对照组相比,服用βAA的动物的累积风险和死亡率的死亡率高出75%至90%。在暴露期间,服用βAA的人群中40%至50%的死亡归因于药物的使用。没有可用的协变量有意义地混淆了βAA与死亡率增加之间的关系。仅仅一个月的宰杀(大概是气候的代名词)就不断改变了这种影响,因为在一年中最温暖的几个月里,生物联系通常最大。尽管在饲养场牛中死亡是罕见的事件,但本文报道的数据提供了令人信服的证据,表明仍然响应于FDA批准的βAA施用而使死亡率增加,并且代表了迄今未量化的不良药物事件。

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