Liu Dan, Mao Wei, Hu Bin, Li Xingxing, Zhao Quanfeng, Zhang Lin, Hu Jing
Department of Pharmacy, The First Affiliated Hospital of Army Medical University (Third Military Medical University), Chongqing, China.
Department of Pharmacy, Nanan People's Hospital of Chongqing, Chongqing, China.
Front Pharmacol. 2024 Jun 25;15:1405023. doi: 10.3389/fphar.2024.1405023. eCollection 2024.
BACKGROUND: Polatuzumab vedotin, the first FDA-approved antibody-drug conjugate (ADC) targeting CD79b, is utilized in the treatment of previously untreated diffuse large B-cell lymphoma (DLBCL) or high-grade B-cell lymphoma (HGBL), as well as relapsed or refractory (R/R) DLBCL. Despite its approval, concerns persist regarding the long-term safety profile of polatuzumab vedotin. This study aims to evaluate the adverse events (AEs) associated with polatuzumab vedotin since its approval in 2019, utilizing data mining strategies applied to the FDA Adverse Event Reporting System (FAERS). METHODS: Signal detection employed four methodologies, including reporting odds ratio (ROR), proportional reporting ratio (PRR), bayesian confidence propagation neural network (BCPNN), and multi-item gamma poisson shrinker (MGPS), to evaluate and quantify the signals of polatuzumab vedotin-associated AEs. Additionally, subgroup analyses based on patients age, gender, and fatal cases were conducted to investigate AEs occurrences in specific subpopulations. RESULTS: A total of 1,521 reports listing polatuzumab vedotin as a "principal suspect (PS)" drug were collected from the FAERS database. Through concurrent compliance with four algorithms, 19 significant Standardized MedDRA Query (SMQ) AEs and 92 significant Preferred Term (PT) AEs were detected. Subgroup analyses revealed a higher incidence of PTs in male patients compared to female patients, increased likelihood of polatuzumab vedotin-associated AEs in elder patients (>65 years), and AEs with a high risk of fatal cases include: blood lactate dehydrogenase increased, cytopenia, and hydronephrosis. The median time to AEs occurrence following polatuzumab vedotin initiation was 18.5 (5∼57.75) days, with 95% of AEs occurred within 162 days. CONCLUSION: This study identified various AEs associated with polatuzumab vedotin, offering critical insights for clinical monitoring and risk identification in patients receiving polatuzumab vedotin therapy.
背景:泊洛妥珠单抗维布妥昔单抗是首个获美国食品药品监督管理局(FDA)批准的靶向CD79b的抗体药物偶联物(ADC),用于治疗先前未经治疗的弥漫性大B细胞淋巴瘤(DLBCL)或高级别B细胞淋巴瘤(HGBL),以及复发或难治性(R/R)DLBCL。尽管已获批准,但对于泊洛妥珠单抗维布妥昔单抗的长期安全性仍存在担忧。本研究旨在利用应用于FDA不良事件报告系统(FAERS)的数据挖掘策略,评估自2019年批准以来与泊洛妥珠单抗维布妥昔单抗相关的不良事件(AE)。 方法:信号检测采用四种方法,包括报告比值比(ROR)、比例报告比(PRR)、贝叶斯置信传播神经网络(BCPNN)和多项目伽马泊松收缩器(MGPS),以评估和量化与泊洛妥珠单抗维布妥昔单抗相关AE的信号。此外,基于患者年龄、性别和死亡病例进行亚组分析,以调查特定亚组中AE的发生情况。 结果:从FAERS数据库中总共收集到1521份将泊洛妥珠单抗维布妥昔单抗列为“主要怀疑(PS)”药物的报告。通过同时符合四种算法,检测到19种显著的标准医学术语集(SMQ)AE和92种显著的首选术语(PT)AE。亚组分析显示,男性患者的PT发生率高于女性患者,老年患者(>65岁)发生与泊洛妥珠单抗维布妥昔单抗相关AE的可能性增加,与死亡病例高风险相关的AE包括:血乳酸脱氢酶升高、血细胞减少和肾盂积水。开始使用泊洛妥珠单抗维布妥昔单抗后AE发生的中位时间为18.5(5~57.75)天,95%的AE在162天内发生。 结论:本研究确定了与泊洛妥珠单抗维布妥昔单抗相关的各种AE,为接受泊洛妥珠单抗维布妥昔单抗治疗的患者的临床监测和风险识别提供了重要见解。
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