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

Abstract

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.

Mining Social Media Data for Biomedical Signals and Health-Related Behavior

“…Thus, analysis of social media data can identify underreported pathology associated with ADRs and further contribute to improvements in population health (Figure 1 shows a sample of social media posts containing drug and symptom mentions). For instance, it has been shown that the combination of clinical FAERS reports and Internet search logs can improve the detection accuracy of ADRs by 19% (63), that discussions on Twitter related to glucocorticoid therapy reveal that insomnia and weight gain are more common adverse events than are reported in the UK regulator's ADR database, and that more serious side effects are comparatively less discussed (52). Another study has (e) Epilepsy Foundation forum post and comments from users asking questions and sharing experiences over drug dosage (Keppra).…”

“…Moreover, social media data allow for a more direct measurement of the perspective of patients on disease, which is often different from that of physicians. Social media can help both patients and practitioners to understand and reduce this disconnect (52), which is known to hinder treatment adherence (53).…”

How Do Glucocorticoids Used in Rheumatic Disease Affect Body Weight? A Narrative Review of the Evidence

“…Patient attitudes toward GC‐associated adverse effects have previously been shown to differ from those of clinicians . One side effect of particular concern to patients is weight gain . In clinical practice, patients commonly decline GCs because of concerns about weight gain, even when potential benefits are high and clinicians believe the benefit/harm balance is favorable.…”

“…For example, there is much research investigating GC‐induced osteoporosis and fractures, supporting numerous clinical guidelines and recommendations (American College of Rheumatology recommendations ; National Institute for Health and Clinical Excellence guidelines). Yet for other events such as weight gain and insomnia, 2 of the side effects that patients are most concerned about , much less is known. So how do patients currently view GC treatment and this potential side effect in the absence of good evidence?…”

“…Analysis of public discussions on social media platforms such as Facebook and Twitter can also be informative and has proven a useful tool to support pharmacovigilance by highlighting patterns not seen in spontaneous reporting from clinicians . In a recent study of Twitter posts mentioning prednisolone or prednisone, insomnia and weight gain were the most commonly discussed adverse events .…”