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帕博西尼的上市后安全性担忧:FDA 不良事件报告系统的比例失调分析。

Post-marketing safety concerns with palbociclib: a disproportionality analysis of the FDA adverse event reporting system.

机构信息

Department of Pharmacy, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.

出版信息

Expert Opin Drug Saf. 2024 May;23(5):637-648. doi: 10.1080/14740338.2024.2338247. Epub 2024 Apr 12.

DOI:10.1080/14740338.2024.2338247
PMID:38564277
Abstract

OBJECTIVES

To explore the association between palbociclib and related adverse events (AEs) in the real world through U.S. Food and Drug Administration Adverse Event Reporting System (FAERS) database.

METHODS

The signal strength of palbociclib-related AEs was done by disproportionality analysis. Clinical priority of palbociclib-related AEs was scored and ranked by assessing five different features. Outcome analysis, time to onset analysis, dose-report /AEs number analysis, and stratification analysis were all performed.

RESULTS

There were 61,821 'primary suspected (PS)' reports of palbociclib and 195,616 AEs associated with palbociclib. The four algorithms simultaneously detected 18 positive signals at the SOC level, and 65 positive signals at the PT level. Bone marrow failure, neuropathy, peripheral, pleural effusion, myelosuppression, pulmonary edema, and pulmonary thrombosis were also found to have positive signals. Gender (female vs male, χ = 5.287,  = 0.022) and age showed significant differences in serious and non-serious reports. Palbociclib-related AEs had a median onset time of 79 days (interquartile range [IQR] 20-264 days).

CONCLUSIONS

The study identified potential Palbociclib-related AEs and offered warnings for special AEs, providing further data for palbociclib safety studies in breast cancer patients. Nonetheless, prospective clinical trials are needed to validate these results and explain their relationship.

摘要

目的

通过美国食品和药物管理局不良事件报告系统(FAERS)数据库,探索帕博西尼与相关不良事件(AE)之间的关联。

方法

采用比例失衡分析评估帕博西尼相关 AE 的信号强度,通过评估五个不同特征对帕博西尼相关 AE 的临床优先级进行评分和排名。进行了结局分析、发病时间分析、剂量报告/AE 数量分析和分层分析。

结果

共收到 61821 例帕博西尼“主要可疑(PS)”报告和 195616 例帕博西尼相关 AE。四种算法同时在 SOC 水平检测到 18 个阳性信号,在 PT 水平检测到 65 个阳性信号。骨髓衰竭、神经病变、周围性、胸腔积液、骨髓抑制、肺水肿和肺血栓形成也被发现存在阳性信号。严重和非严重报告的性别(女性与男性,χ²=5.287,P=0.022)和年龄存在显著差异。帕博西尼相关 AE 的中位发病时间为 79 天(四分位距 [IQR] 20-264 天)。

结论

本研究确定了潜在的帕博西尼相关 AE,并对特殊 AE 发出了警告,为乳腺癌患者帕博西尼安全性研究提供了进一步的数据。然而,需要前瞻性临床试验来验证这些结果并解释其相关性。

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