Chirality Status by Adverse Drug Reactions
A total of 583 ADRs were among the reasons of withdrawal of the drugs evaluated. Fifty-two and a half percent (n=306) of those were related to achiral drugs, 28.3% (n=165) to chiral mixtures and 19.2% (n=112) to pure enantiomers. Among the most encountered ADRs, hepatotoxicity was significantly less common in pure enantiomers (5.4%) compared to chiral mixtures (12.7%, p=0.04) and achirals (17.0%, p<0.01). Cardiovascular ADRs were significantly more common in chiral mixtures (14.5%) compared to that in achiral drugs (7.5%, p=0.02), with no difference from pure enantiomers (11.6%, p>0.05). Drug abuse for a reason of withdrawal was found to be less common in achiral drugs (5.2%) than that in chiral mixtures (13.3%, p<0.01) and pure enantiomers (11.6%, p=0.03). In addition, dermatological ADRs were significantly less common in pure enantiomers compared to that in achiral drugs (1.8% vs. 8.8%, p<0.01) for pure enantiomers (Table 2).