替雷利珠单抗的上市后安全性问题:FDA不良事件报告系统的比例失衡分析

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

作者信息

Li Chen, Ding Yi, Cai Shanshan, Liu Bai Cheng, Wang Xiufeng

机构信息

Clinical Discipline Construction Center, Graduate School of Shanxi Medical University, Taiyuan, China.

Department of Orthopedic Trauma, Zhuji People's Hospital of Zhejiang Province, Zhuji, China.

出版信息

Front Immunol. 2025 May 26;16:1596842. doi: 10.3389/fimmu.2025.1596842. eCollection 2025.

Abstract

BACKGROUND

Tislelizumab is an anti-programmed cell death protein 1(anti-PD-1) monoclonal antibody, which was approved by the Food and Drug Administration(FDA) on March 14, 2024. However, clinical studies are often limited by small sample sizes, and thus a more comprehensive evaluation of the safety of Tislelizumab, particularly its immune-related adverse reactions, is urgently needed.

METHOD

Disproportionality analysis was used in this study to assess the safety of Tislelizumab in clinical practice by analyzing all adverse event reports from the FDA Adverse Event Reporting System database, starting from the first quarter of 2024, where Tislelizumab was identified as the primary suspected drug. Two disproportionality analysis methods, reporting odds ratio (ROR) and Bayesian confidence propagation neural network (BCPNN), were utilized to investigate the adverse reactions related to Tislelizumab. Additionally, the Weibull distribution was employed to examine the time-dependent changes in the incidence of adverse events.

RESULTS

Consistent with the drug label, this study identified significant positive signals for adverse reactions, including myelosuppression, hepatic dysfunction, pruritus, rash, and exfoliative dermatitis. Notably, this study also identified several adverse reactions not documented in the drug label, including palmar-plantar erythrodysaesthesia syndrome, immune-mediated cystitis, and renal cysts. Adverse reactions associated with Tislelizumab generally manifested within the first month of treatment. In terms of immune-related adverse reactions, Tislelizumab demonstrated lower signal values compared to other immune checkpoint inhibitors.

CONCLUSION

This study comprehensively reviews the safety profile of Tislelizumab, thereby providing clinicians with crucial safety information for prescribing this drug. Due to its relatively low risk of immune-related adverse events (irAEs), Tislelizumab may serve as a promising candidate for combination therapy with other immune checkpoint inhibitors (ICIs). Novel combination strategies involving Tislelizumab and other ICIs are anticipated to provide new therapeutic opportunities for patients experiencing irAEs.

摘要

背景

替雷利珠单抗是一种抗程序性细胞死亡蛋白1(抗PD-1)单克隆抗体,于2024年3月14日获得美国食品药品监督管理局(FDA)批准。然而,临床研究往往受限于小样本量,因此迫切需要对替雷利珠单抗的安全性,尤其是其免疫相关不良反应进行更全面的评估。

方法

本研究采用比例失衡分析,通过分析FDA不良事件报告系统数据库中从2024年第一季度开始的所有不良事件报告来评估替雷利珠单抗在临床实践中的安全性,其中替雷利珠单抗被确定为主要怀疑药物。采用两种比例失衡分析方法,即报告比值比(ROR)和贝叶斯置信传播神经网络(BCPNN)来研究与替雷利珠单抗相关的不良反应。此外,采用威布尔分布来检查不良事件发生率的时间依赖性变化。

结果

与药品标签一致,本研究确定了不良反应的显著阳性信号,包括骨髓抑制、肝功能障碍、瘙痒、皮疹和剥脱性皮炎。值得注意的是,本研究还确定了药品标签中未记录的几种不良反应,包括手足红斑感觉异常综合征、免疫介导的膀胱炎和肾囊肿。与替雷利珠单抗相关的不良反应通常在治疗的第一个月内出现。在免疫相关不良反应方面,与其他免疫检查点抑制剂相比,替雷利珠单抗的信号值较低。

结论

本研究全面回顾了替雷利珠单抗的安全性概况,从而为临床医生提供了开具此药的关键安全信息。由于其免疫相关不良事件(irAEs)风险相对较低,替雷利珠单抗可能是与其他免疫检查点抑制剂(ICIs)联合治疗的有前景的候选药物。涉及替雷利珠单抗和其他ICIs的新型联合策略有望为经历irAEs的患者提供新的治疗机会。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b6b7/12146294/a20442c36055/fimmu-16-1596842-g001.jpg

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