Huang Jinlong, Zhang Miaomiao, Lin Jingyang, Yang Xiuli, Huang Ping, Zheng Xiaochun
Center for Clinical Pharmacy, Cancer Center, Department of Pharmacy, Zhejiang Provincial People's Hospital (Affiliated People's Hospital), Hangzhou Medical College, 158 Shangtang Rd, Gongsu District, Hangzhou, 310014, Zhejiang, China.
School of Pharmacy, Hangzhou Normal University, Hangzhou, Zhejiang, China.
Sci Rep. 2025 Apr 4;15(1):11628. doi: 10.1038/s41598-025-96427-3.
Proteasome inhibitor analogs (PIs) have significantly improved the degree of remission and survival rate of patients with multiple myeloma. However, serious adverse events (AEs) have hindered their clinical application. This study analyzed the AEs reported in the U.S. Food and Drug Administration Adverse Event Reporting System (FAERS) database to determine the safety profile and differences for the PI drugs bortezomib, carfilzomib, and ixazomib. The reporting odds ratio (ROR) was used to detect safety signals. Significant safety signals were detected based on system-organ classification (SOC). For bortezomib, the most significant SOC signal was "blood and lymphatic system disorders" (ROR = 3.47, 95% CI 3.37-3.57), while the most significant PT signal was "enteric neuropathy" (ROR = 134.96, 95% CI 45.67-398.79). For carfilzomib, the most significant SOC signal being "blood and lymphatic system disorders" (ROR = 4.34, 95% CI 4.17-4.53), while the most significant PT signal was "light chain analysis increased" (ROR = 76.65, 95% CI 57.07-102.96). For ixazomib, the most significant SOC signal was "gastrointestinal disorders" (ROR = 2.04, 95% CI 1.96-2.12), while the most significant PT signal was "light chain analysis increased" (ROR = 67.15, 95% CI 45.36-99.42). For bortezomib and carfilzomib, the top 20 reported PTs were consistent with AEs listed in the drug information. For ixazomib, six unexpected AEs were observed: asthenia, malaise, pyrexia, decreased appetite, dehydration, and falls. The PIs were consistent with the early failure model based on time-series analysis of the occurrence of adverse reactions to the drug. The data mined from FAERS generates new AE signals, and further clinical studies are needed to validate these findings.
蛋白酶体抑制剂类似物(PIs)显著提高了多发性骨髓瘤患者的缓解程度和生存率。然而,严重不良事件(AEs)阻碍了它们的临床应用。本研究分析了美国食品药品监督管理局不良事件报告系统(FAERS)数据库中报告的不良事件,以确定PI药物硼替佐米、卡非佐米和伊沙佐米的安全性概况及差异。采用报告比值比(ROR)来检测安全信号。基于系统器官分类(SOC)检测到显著的安全信号。对于硼替佐米,最显著的SOC信号是“血液及淋巴系统疾病”(ROR = 3.47,95%CI 3.37 - 3.57),而最显著的首选术语(PT)信号是“肠道神经病变”(ROR = 134.96,95%CI 45.67 - 398.79)。对于卡非佐米,最显著的SOC信号是“血液及淋巴系统疾病”(ROR = 4.34,95%CI 4.17 - 4.53),而最显著的PT信号是“轻链分析增加”(ROR = 76.65,95%CI 57.07 - 102.96)。对于伊沙佐米,最显著的SOC信号是“胃肠道疾病”(ROR = 2.04,95%CI 1.96 - 2.12),而最显著的PT信号是“轻链分析增加”(ROR = 67.15,95%CI 45.36 - 99.)。对于硼替佐米和卡非佐米,报告的前20个PT与药物信息中列出的不良事件一致。对于伊沙佐米,观察到6种意外不良事件:乏力、不适、发热、食欲减退、脱水和跌倒。基于对药物不良反应发生情况的时间序列分析,PIs与早期失效模型一致。从FAERS挖掘的数据产生了新的AE信号,需要进一步的临床研究来验证这些发现。
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