Cohen Stanley, Curtis Jeffrey R, DeMasi Ryan, Chen Yan, Fan Haiyun, Soonasra Arif, Fleischmann Roy
Metroplex Clinical Research Center, Dallas, TX, USA.
University of Alabama at Birmingham, Birmingham, AL, USA.
Rheumatol Ther. 2018 Jun;5(1):283-291. doi: 10.1007/s40744-018-0097-3. Epub 2018 Feb 22.
Post-marketing surveillance (PMS) is an integral part of monitoring adverse events (AEs) following approval of new drugs. Tofacitinib is an oral Janus kinase inhibitor for the treatment of rheumatoid arthritis (RA). An analysis of PMS reports was conducted to evaluate the safety of tofacitinib in a post-marketing setting.
Worldwide tofacitinib PMS data received in the Pfizer safety database from November 6, 2012 (first marketing authorization of tofacitinib) to November 5, 2015 were analyzed. Serious AEs (SAEs) of interest were reviewed and reporting rates (RRs) were calculated by dividing the number of SAEs by the estimated 100 patient-years of exposure. Patient exposure was calculated based on estimated worldwide sales and an estimated daily regimen of tofacitinib 5 mg twice daily.
During the 3-year reporting period, worldwide post-marketing exposure to tofacitinib since approval was estimated to be 34,223 patient-years. In total, 9291 case reports (82.9% non-serious) were received and 25,417 AEs, 102 fatal cases, and 4352 SAEs were reported. The RRs (per 100 patient-years) for SAEs of interest by Medical Dictionary for Regulatory Activities System Organ Class were 2.57 for infections, 0.91 for gastrointestinal disorders, 0.60 for respiratory disorders, 0.45 for neoplasms, 0.43 for cardiac disorders, and 0.12 for hepatobiliary disorders.
Although there are limitations to these data, no new safety risks were revealed in this real-world setting compared with the safety profile identified in the tofacitinib RA clinical development program. Any risks identified through the tofacitinib development program and PMS will continue to be monitored through pharmacovigilance surveillance.
Pfizer Inc.
上市后监测(PMS)是新药获批后监测不良事件(AE)的一个组成部分。托法替布是一种用于治疗类风湿关节炎(RA)的口服Janus激酶抑制剂。开展了一项上市后监测报告分析,以评估托法替布在上市后环境中的安全性。
分析了2012年11月6日(托法替布首次上市许可)至2015年11月5日期间辉瑞安全数据库中收到的全球托法替布上市后监测数据。对感兴趣的严重不良事件(SAE)进行了审查,并通过将SAE的数量除以估计的100患者年暴露量来计算报告率(RR)。患者暴露量是根据全球估计销售额和托法替布5毫克每日两次的估计每日用药方案计算的。
在3年报告期内,自批准以来全球托法替布的上市后暴露量估计为34223患者年。共收到9291份病例报告(82.9%为非严重报告),报告了25417例不良事件、102例死亡病例和4352例严重不良事件。根据监管活动医学词典系统器官分类,感兴趣的严重不良事件的报告率(每100患者年)分别为:感染2.57、胃肠道疾病0.91、呼吸系统疾病0.60、肿瘤0.45、心脏疾病0.43、肝胆疾病0.12。
尽管这些数据存在局限性,但与托法替布类风湿关节炎临床开发项目中确定的安全性概况相比,在这一现实世界环境中未发现新的安全风险。通过托法替布开发项目和上市后监测确定的任何风险将继续通过药物警戒监测进行监测。
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