{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T06:20:42Z","timestamp":1783405242809,"version":"3.54.6"},"reference-count":56,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T00:00:00Z","timestamp":1783382400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Etomidate is a widely used intravenous anesthetic, yet concerns persist regarding its potential for adverse drug reactions (ADRs) beyond well-known adrenal suppression. Pre-marketing trials may not fully capture its long-term or rare safety profile, necessitating continuous post-marketing surveillance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective pharmacovigilance study was performed based on the U.S. FDA Adverse Event Reporting System (FAERS) database (Q1 2004\u2013Q2 2025). Disproportionality analysis using ROR, PRR, BCPNN and EBGM algorithms was conducted and the corresponding 95% CIs were calculated. ADRs meeting the criteria of all four algorithms were considered positive signals significantly associated with the target drug.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Totally 318 ADRs were acquired, of which 59 preferred terms (PTs) and two system organ classes (SOCs) met four algorithm criteria. In addition to known cardiovascular, muscular and adrenal related PTs, novel positive signals included cardiac arrest (\n                      <jats:italic>n<\/jats:italic>\n                      = 33), seizure (\n                      <jats:italic>n<\/jats:italic>\n                      = 12), drug abuse (\n                      <jats:italic>n<\/jats:italic>\n                      = 10), hypokalaemia (\n                      <jats:italic>n<\/jats:italic>\n                      = 9) and bruxism (\n                      <jats:italic>n<\/jats:italic>\n                      = 9) were found to be correlated with etomidate. As for SOCs, cardiac disorders (\n                      <jats:italic>n<\/jats:italic>\n                      = 100) remains significantly associated with etomidate while endocrine disorders (\n                      <jats:italic>n<\/jats:italic>\n                      = 38) was uncovered as a novel signal.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This study confirmed known risks and identified novel ADRs of etomidate. These findings underscore the need for heightened clinical vigilance and further investigation into its long-term safety profile.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2026.1780171","type":"journal-article","created":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T05:46:00Z","timestamp":1783403160000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Beyond adrenal suppression: a comprehensive post-marketing safety profile of etomidate from real world data"],"prefix":"10.3389","volume":"13","author":[{"given":"Huiyi","family":"Deng","sequence":"first","affiliation":[{"name":"Department of Gynecology, the Eighth Affiliated Hospital of Southern Medical University (The First People's Hospital of Shunde)","place":["Foshan, Guangdong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wujiang","family":"Lai","sequence":"additional","affiliation":[{"name":"Department of Gynecology, the Eighth Affiliated Hospital of Southern Medical University (The First People's Hospital of Shunde)","place":["Foshan, Guangdong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ying","family":"Xiang","sequence":"additional","affiliation":[{"name":"Senior Department of Traditional Chinese Medicine, the Sixth Medical Center of PLA General Hospital","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zewen","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, the Eighth Affiliated Hospital of Southern Medical University (The First People's Hospital of Shunde)","place":["Foshan, Guangdong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiemei","family":"Liang","sequence":"additional","affiliation":[{"name":"Department of Gynecology, the Eighth Affiliated Hospital of Southern Medical University (The First People's Hospital of Shunde)","place":["Foshan, Guangdong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yiwen","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, the Eighth Affiliated Hospital of Southern Medical University (The First People's Hospital of Shunde)","place":["Foshan, Guangdong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiale","family":"Liang","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, the Eighth Affiliated Hospital of Southern Medical University (The First People's Hospital of Shunde)","place":["Foshan, Guangdong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,7,7]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"213","DOI":"10.1093\/bja\/48.3.213","article-title":"A dose-response relationship for etomidate, with some observations on cumulation","volume":"48","author":"Kay","year":"1976","journal-title":"Br J Anaesth."},{"key":"B2","doi-asserted-by":"publisher","first-page":"803","DOI":"10.1093\/bja\/52.8.803","article-title":"Induction of anaesthesia with etomidate: haemodynamic study of 36 patients","volume":"52","author":"Criado","year":"1980","journal-title":"Br J Anaesth."},{"key":"B3","doi-asserted-by":"publisher","first-page":"1320","DOI":"10.1213\/ANE.0000000000004654","article-title":"The influence of hemorrhagic shock on the disposition and effects of intravenous anesthetics: a narrative review","volume":"130","author":"Egan","year":"2020","journal-title":"Anesth Analg."},{"key":"B4","doi-asserted-by":"publisher","first-page":"249","DOI":"10.1007\/s12024-023-00596-4","article-title":"The need to monitor emerging issues in etomidate usage: the misuse or abuse potential","volume":"20","author":"Uhm","year":"2024","journal-title":"Forensic Sci Med Pathol."},{"key":"B5","doi-asserted-by":"publisher","first-page":"452","DOI":"10.1016\/j.gie.2017.02.033","article-title":"Etomidate versus propofol sedation for complex upper endoscopic procedures: a prospective double-blinded randomized controlled trial","volume":"86","author":"Kim","year":"2017","journal-title":"Gastrointest Endosc."},{"key":"B6","doi-asserted-by":"publisher","first-page":"649","DOI":"10.5009\/gnl18514","article-title":"Using etomidate and midazolam for screening colonoscopies results in more stable hemodynamic responses in patients of all ages","volume":"13","author":"Lee","year":"2019","journal-title":"Gut Liver."},{"key":"B7","doi-asserted-by":"publisher","first-page":"504","DOI":"10.1093\/bja\/80.4.504","article-title":"Thiopental or etomidate for rapid sequence induction with rocuronium","volume":"80","author":"Fuchs-Buder","year":"1998","journal-title":"Br J Anaesth."},{"key":"B8","doi-asserted-by":"publisher","first-page":"737","DOI":"10.1111\/j.1365-2044.2005.04325.x","article-title":"Etomidate for emergency anaesthesia; 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