Wang Kaixuan, Wang Mengmeng, Li Wensheng, Wang Xiaohui
Department of Urology Surgery, The First Affiliated Hospital, and College of Clinical Medicine of Henan University of Science and Technology, Luoyang, China.
Department of Oncology, the Second Affiliated Hospital of Henan University of Science and Technology, Luoyang, China.
Front Pharmacol. 2024 Jun 13;15:1408135. doi: 10.3389/fphar.2024.1408135. eCollection 2024.
Tivozanib, a vascular endothelial growth factor tyrosine kinase inhibitor, has demonstrated efficacy in a phase III clinical trials for the treatment of renal cell carcinoma. However, comprehensive evaluation of its long-term safety profile in a large sample population remains elusive. The current study assessed Tivozanib-related adverse events of real-world through data mining of the US Food and Drug Administration Adverse Event Reporting System FDA Adverse Event Reporting System.
Disproportionality analyses, utilizing reporting odds ratio proportional reporting ratio Bayesian confidence propagation neural network and multi-item gamma Poisson shrinker (MGPS) algorithms, were conducted to quantify signals of Tivozanib-related AEs. Weibull distribution was used to predict the varying risk incidence of AEs over time.
Out of 5,361,420 reports collected from the FAERS database, 1,366 reports of Tivozanib-associated AEs were identified. A total of 94 significant disproportionality preferred terms (PTs) conforming to the four algorithms simultaneously were retained. The most common AEs included fatigue, diarrhea, nausea, blood pressure increased, decreased appetite, and dysphonia, consistent with prior specifications and clinical trials. Unexpected significant AEs such as dyspnea, constipation, pain in extremity, stomatitis, and palmar-plantar erythrodysaesthesia syndrome was observed. The median onset time of Tivozanib-related AEs was 37 days (interquartile range [IQR] 11.75-91 days), with a majority (n = 127, 46.35%) occurring within the initial month following Tivozanib initiation.
Our observations align with clinical assertions regarding Tivozanib's safety profile. Additionally, we unveil potential novel and unexpected AE signatures associated with Tivozanib administration, highlighting the imperative for prospective clinical studies to validate these findings and elucidate their causal relationships. These results furnish valuable evidence to steer future clinical inquiries aimed at elucidating the safety profile of Tivozanib.
替沃扎尼是一种血管内皮生长因子酪氨酸激酶抑制剂,已在治疗肾细胞癌的III期临床试验中显示出疗效。然而,在大样本人群中对其长期安全性概况进行全面评估仍然难以实现。本研究通过对美国食品药品监督管理局不良事件报告系统(FDA不良事件报告系统)的数据挖掘,评估了替沃扎尼在现实世界中相关的不良事件。
采用报告比值比、比例报告比、贝叶斯置信传播神经网络和多项目伽马泊松收缩器(MGPS)算法进行不成比例分析,以量化替沃扎尼相关不良事件的信号。使用威布尔分布预测不良事件随时间变化的风险发生率。
从FAERS数据库收集的5361420份报告中,识别出1366份替沃扎尼相关不良事件报告。总共保留了94个同时符合四种算法的显著不成比例优先术语(PTs)。最常见的不良事件包括疲劳、腹泻、恶心、血压升高、食欲下降和声音嘶哑,与先前的说明书和临床试验一致。观察到意外的显著不良事件,如呼吸困难、便秘、肢体疼痛、口腔炎和手足红斑感觉异常综合征。替沃扎尼相关不良事件的中位发病时间为37天(四分位间距[IQR]11.75 - 91天),大多数(n = 127,46.35%)发生在开始使用替沃扎尼后的第一个月内。
我们的观察结果与关于替沃扎尼安全性概况的临床论断一致。此外,我们揭示了与替沃扎尼给药相关的潜在新的和意外的不良事件特征,强调前瞻性临床研究验证这些发现并阐明其因果关系的必要性。这些结果为指导未来旨在阐明替沃扎尼安全性概况的临床研究提供了有价值的证据。