Department of Pharmacy, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Graduate School of Pharmaceutical Sciences, University of Tokyo, Tokyo, Japan.
Front Immunol. 2023 May 15;14:1169735. doi: 10.3389/fimmu.2023.1169735. eCollection 2023.
Risankizumab, a humanized IgG1 monoclonal antibody that selectively inhibits IL-23, is currently approved for the treatment of moderate-to-severe plaque psoriasis and Crohn's disease. The real-world safety study of risankizumab in a large- sample population is currently lacking. The aim of this study was to evaluate risankizumab-associated adverse events (AEs) and characterize the clinical priority through the data mining of the Food and Drug Administration (FDA) Adverse Event Reporting System (FAERS).
Disproportionality analyses were performed by calculating the reporting odds ratios (RORs), deemed significant when the lower limit of the 95% confidence interval was greater than 1, to quantify the signals of risankizumab-related AEs from the second quarter (Q2) of 2019 to 2022 Q3. Serious and non-serious cases were compared, and signals were prioritized using a rating scale.
Risankizumab was recorded in 10,235 reports, with 161 AEs associated with significant disproportionality. Of note, 37 PTs in at least 30 cases were classified as unexpected AEs, which were uncovered in the drug label, such as myocardial infarction, cataract, pancreatitis, diabetes mellitus, stress, and nephrolithiasis. 74.68%, 25.32%, and 0% PTs were graded as weak, moderate, and strong clinical priorities, respectively. A total of 48 risankizumab-related AEs such as pneumonia, cerebrovascular accident, cataract, loss of consciousness, cardiac disorder, hepatic cirrhosis, and thrombosis, were more likely to be reported as serious AEs. The median TTO of moderate and weak signals related to risankizumab was 115 (IQR 16.75-305) and 124 (IQR 29-301) days, respectively. All of the disproportionality signals had early failure type features, indicating that risankizumab-associated AEs gradually decreased over time.
Our study found potential new AE signals and provided valuable evidence for clinicians to mitigate the risk of risankizumab-associated AEs based on an extensive analysis of a large-scale postmarketing international safety database.
利纳西单抗是一种人源化 IgG1 单克隆抗体,可选择性抑制 IL-23,目前已被批准用于治疗中重度斑块型银屑病和克罗恩病。目前缺乏利纳西单抗在大样本人群中的真实世界安全性研究。本研究旨在通过对食品药品监督管理局(FDA)不良事件报告系统(FAERS)的数据挖掘,评估利纳西单抗相关不良事件(AE)并对其临床优先级进行特征描述。
通过计算报告比值比(ROR)进行比例失调分析,当 95%置信区间的下限大于 1 时,认为信号具有统计学意义,以量化 2019 年第二季度(Q2)至 2022 年第三季度期间利纳西单抗相关 AE 的信号。比较严重和非严重病例,并使用评分量表对信号进行优先级排序。
共记录到 10235 份报告,其中 161 例 AE 与显著比例失调相关。值得注意的是,至少 30 例中有 37 个治疗类别(PTs)被归类为意外 AE,这些 AE 未在药物标签中说明,如心肌梗死、白内障、胰腺炎、糖尿病、应激和肾结石。分别有 74.68%、25.32%和 0%的 PTs 被评为弱、中、强临床优先级。共有 48 例利纳西单抗相关 AE,如肺炎、脑血管意外、白内障、意识丧失、心脏疾病、肝硬化和血栓形成,更有可能被报告为严重 AE。与利纳西单抗相关的中度和弱信号的中位 TTO 分别为 115(IQR 16.75-305)和 124(IQR 29-301)天。所有比例失调信号均具有早期失效类型特征,表明利纳西单抗相关 AE 随时间逐渐减少。
我们的研究发现了潜在的新 AE 信号,并为临床医生提供了有价值的证据,以便基于对大规模上市后国际安全性数据库的广泛分析来降低利纳西单抗相关 AE 的风险。