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评估抗体药物偶联物相关间质性肺病的安全性问题:FDA 不良事件报告系统的真实世界药物警戒评估。

Assessing safety concerns of interstitial lung disease associated with antibody-drug conjugates: a real-world pharmacovigilance evaluation of the FDA adverse event reporting system.

机构信息

Department of Pharmacy, Women and Children's Hospital, School of Medicine, Xiamen University, 10# Zhenhai Road, Xiamen, China.

School of Pharmaceutical, Fujian University of Traditional Chinese Medicine, Fuzhou, China.

出版信息

Int J Clin Pharm. 2024 Jun;46(3):614-622. doi: 10.1007/s11096-023-01673-y. Epub 2023 Dec 15.

Abstract

BACKGROUND

Antibody-drug conjugates have revolutionized cancer therapy due to their selectivity and efficacy. However, concerns have been raised regarding the potential effects of trastuzumab deruxtecan in interstitial lung diseases.

AIM

This study aimed to investigate the safety signals and time to onset of antibody-drug conjugates induced interstitial lung disease.

METHOD

We utilized the FDA Adverse Event Reporting System database (2004-2022) to identify interstitial lung disease safety signals in 13 FDA-approved antibody-drug conjugates. Disproportionality analysis was conducted to estimate the reporting odds ratios for interstitial lung disease.

RESULTS

Seven antibody-drug conjugates exhibited safety signals of interstitial lung disease: trastuzumab deruxtecan [reporting odds ratio, ROR (95% confidence intervals, CI) = 64.15 (57.07-72.10)], enfortumab vedotin [ROR (95% CI) = 5.24 (3.25-8.43)], trastuzumab emtansine [ROR (95% CI) = 3.62 (2.90-4.53)], brentuximab vedotin [ROR (95% CI) = 3.22 (2.49-4.17)], polatuzumab vedotin [ROR (95% CI) = 2.56 (1.59-4.12)], gemtuzumab ozogamicin [ROR (95% CI) = 2.53 (1.70-3.78)], and inotuzumab ozogamicin [ROR (95% CI) = 2.33 (1.21-4.49)]. Five antibody-drug conjugates with limited reports were excluded from further analysis: belantamab mafodotin, loncastuximab tesirine, mirvetuximab sorafenib, tisotumab vedotin, and moxetumomab pasudotox. Japan and the United States were the primary reporting countries.

CONCLUSION

This real-world study highlights high safety signals of interstitial lung disease associated with antibody-drug conjugates. Clinicians should be aware of these safety concerns and risk factors and implement early identification measures for their patients. Future research should prioritize comprehensively exploring the relationship between antibody-drug conjugates and lung diseases.

摘要

背景

抗体药物偶联物因其选择性和疗效而彻底改变了癌症治疗。然而,人们对曲妥珠单抗 deruxtecan 潜在的间质性肺病效应提出了担忧。

目的

本研究旨在调查抗体药物偶联物引起的间质性肺病的安全信号和发病时间。

方法

我们利用美国食品药品监督管理局不良事件报告系统数据库(2004-2022 年),鉴定了 13 种已获美国食品药品监督管理局批准的抗体药物偶联物中与间质性肺病相关的安全信号。采用不相称性分析来估计间质性肺病的报告比值比。

结果

七种抗体药物偶联物显示出间质性肺病的安全信号:曲妥珠单抗 deruxtecan[报告比值比(95%置信区间,CI)=64.15(57.07-72.10)]、恩福妥珠单抗 vedotin[报告比值比(95%CI)=5.24(3.25-8.43)]、曲妥珠单抗 emtansine[报告比值比(95%CI)=3.62(2.90-4.53)]、本妥昔单抗 vedotin[报告比值比(95%CI)=3.22(2.49-4.17)]、泊洛妥珠单抗 vedotin[报告比值比(95%CI)=2.56(1.59-4.12)]、吉妥珠单抗奥佐米星[报告比值比(95%CI)=2.53(1.70-3.78)]和伊妥珠单抗奥佐米星[报告比值比(95%CI)=2.33(1.21-4.49)]。五种报告有限的抗体药物偶联物被排除在进一步分析之外:贝兰他单抗 mafodotin、洛那曲妥珠单抗 tesirine、米拉妥珠单抗 sorafenib、替西木单抗 vedotin 和莫昔妥珠单抗 pasudotox。日本和美国是主要的报告国。

结论

这项真实世界研究强调了与抗体药物偶联物相关的间质性肺病的高安全信号。临床医生应意识到这些安全问题和风险因素,并为其患者实施早期识别措施。未来的研究应优先全面探讨抗体药物偶联物与肺部疾病之间的关系。

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