Minnema L A, Giezen T J, Egberts T C G, Leufkens H G M, Gardarsdottir H
Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, The Netherlands.
Medicines Evaluation Board, Utrecht, The Netherlands.
Eur J Neurol. 2020 Jul;27(7):1250-1256. doi: 10.1111/ene.14259. Epub 2020 May 10.
Clinical decision making is facilitated by healthcare professionals' and patients' adequate knowledge of the adverse events. This is especially important for biologicals used for treating multiple sclerosis (MS). So far, little is known about whether different information sources report adverse events consistently.
Biologicals authorized by the European Medicines Agency for the treatment of MS were included in this study. Information on adverse events derived from phase 3 clinical trials from European Public Assessment Reports (EPARs) and from scientific publications was compared.
In the study, eight biologicals used for the treatment of MS were included for which the EPAR and/or scientific publication reported a total of 707 adverse events. Approximately one-third of the adverse events was reported in both the EPAR and scientific publication, one-third was only reported in the EPAR and one-third only in the scientific publication. Serious adverse events and adverse events that regulators classified as 'important identified risk' were significantly more often reported in both sources compared to adverse events not classified as such (respectively, 38% vs. 30% and 49% vs. 30%). Adverse events only reported in the EPAR or in the scientific publication were, in general, not described in the benefit-risk section or abstract, which were considered to be the most important sections of the documents.
This study showed that there is substantial discordance in the reporting of adverse events on the same phase 3 trials between EPARs and scientific publications. To support optimal clinical decision making, both documents should be considered.
医疗保健专业人员和患者对不良事件有足够的了解有助于临床决策。这对于用于治疗多发性硬化症(MS)的生物制剂尤为重要。到目前为止,对于不同信息来源报告不良事件是否一致知之甚少。
本研究纳入了欧洲药品管理局批准用于治疗MS的生物制剂。比较了来自欧洲公共评估报告(EPAR)和科学出版物的3期临床试验中的不良事件信息。
在该研究中,纳入了8种用于治疗MS的生物制剂,EPAR和/或科学出版物共报告了707起不良事件。约三分之一的不良事件在EPAR和科学出版物中均有报告,三分之一仅在EPAR中报告,三分之一仅在科学出版物中报告。与未分类的不良事件相比,严重不良事件和监管机构归类为“重要确定风险”的不良事件在两种来源中报告的频率明显更高(分别为38%对30%和49%对30%)。仅在EPAR或科学出版物中报告的不良事件,通常在效益风险部分或摘要中未作描述,而这些部分被认为是文件中最重要的部分。
本研究表明,EPAR和科学出版物在同一3期试验不良事件报告方面存在重大不一致。为支持最佳临床决策,两份文件均应予以考虑。