Real-World Safety Profile of Biologics Used in Rheumatology: A Six-Year Observational Pharmacovigilance Study in the Calabria Region

Adverse event profile of lomustine and temozolomide: a descriptive analysis from WHO-VigiAccess

Introduction

In gliomas, various oncogenic factors can lead to an imbalance between cell proliferation and apoptosis. Lomustine inhibits tumor cell growth by disrupting DNA replication and repair mechanisms. In contrast, temozolomide, an imidazole tetrazine compound, promotes cell apoptosis through DNA alkylation. The present study aimed to systematically analyze and compare the adverse drug reactions (ADRs) associated with lomustine and temozolomide, as reported in the World Health Organization (WHO) VigiAcess database.

Methods

Utilizing a retrospective descriptive analysis design, this study focused on two commercially available anti-glioma drugs. ADR reports pertaining to these medications were collected from the WHO-VigiAccess database. The data collection process involved gathering detailed information on various parameters, including age groups, gender, and geographical distribution of patients involved in the ADR reports. Additionally, the study examined the disease systems and symptoms reported alongside the adverse reactions, as recorded in the annual ADR summaries generated by the WHO. By calculating the proportion of adverse events reported for each drug, this investigation provided a comparative analysis of both the similarities and differences in the adverse reactions observed across the two anti-glioma drugs.

Results

At the time of the search, a total of 22,854 adverse events (AEs) associated with the two anti-glioma drugs were documented in the VigiAccess database. Lomustine exhibits a higher reporting rate concerning blood and lymphatic system disorders, gastrointestinal disorders, and hepatobiliary disorders. In contrast, Temozolomide has a higher reporting rate for general disorders and administration site conditions, nervous system disorders, and skin and subcutaneous tissue disorders. The top five types of AEs for anti-glioma drugs are as follows: general disorders and administration site conditions (8,825 cases, 38.61%), blood and lymphatic system disorders (7,369 cases, 32.24%), gastrointestinal disorders (5,614 cases, 24.56%), nervous system disorders (5,047 cases, 22.08%), and investigations (4,855 cases, 21.24%).

Conclusion

The present comparative observational study indicates that these inhibitors are associated with both common and specific adverse reactions, as documented in ADR reports. Clinicians should formulate individualized treatment plans that consider the adverse reactions linked to various drugs and the specific conditions of each patient, thereby promoting the rational use of these costly medications.

Characteristics of adverse reactions of three anti-glioma drugs in WHO-VigiAccess

Introduction

Antitumor medications such as Avastin, Berubicin, and Temozolomide have fundamentally transformed the treatment landscape for gliomas by exhibiting potent pharmacological effects on both high-grade and low-grade gliomas. This study aims to determine which anti-glioma medication presents the lowest risk for personalized use in clinical patients by assessing the adverse drug reactions (ADRs) associated with these medications as reported in the World Health Organization (WHO) VigiAcess database, and by comparing the characteristics of adverse responses among the three drugs.

Methods

This investigation employs a retrospective descriptive analysis method. We compiled ADR reports for three commercially available anti-glioma medications from WHO-VigiAccess, gathering data on the disease systems and symptoms associated with ADRs, as well as the age, gender, and geographic characteristics of the patients represented in the reports. To provide a reference for clinical treatment, we analyzed the similarities and differences in the adverse reactions of the three medications by calculating the proportion of adverse reactions recorded for each drug.

Results

A total of 132,471 adverse events (AEs) associated with three anti-glioma drugs were reported in VigiAccess. The analysis revealed that the ten most frequently reported AEs included bone marrow suppression, myalgia, leukopenia, thrombocytopenia, nausea, vomiting, death, rhabdomyolysis, disease progression, and a decrease in neutrophil count. The five most common categories of AEs related to anti-glioma drugs were blood and lymphatic system diseases (20,233 cases, 15.2%), general disorders and administration site conditions (26,973 cases, 20.3%), gastrointestinal dysfunction (22,061 cases, 16.7%), necessitating further investigations (18,285 cases, 13.8%), and musculoskeletal and connective tissue diseases (30,695 cases, 23.1%). Notably, the adverse events associated with Avastin were more pronounced in the category of musculoskeletal and connective tissue diseases compared to the other two drugs. Furthermore, Berubicin exhibited a particularly high proportion of blood and lymphatic system disease AEs, reaching 45.6%, which was significantly greater than those observed for the other two drugs.

Conclusion

There is limited correlation between antineoplastic medications and ADRs. Current comparative observational studies indicate that these inhibitors are associated with both common and specific adverse effects documented in the ADR reports submitted to the World Health Organization (WHO).

Lipid- and polymer-based formulations containing TNF-α inhibitors for the treatment of inflammatory bowel diseases

Monoclonal antibodies inhibiting tumor necrosis factor-alpha (iTNF-α) have revolutionized the therapeutic regimen of inflammatory bowel disease, but their main drawback is the parenteral route of administration they require. An alternative approach lies in the delivery of these molecules to the area involved in the inflammatory process by means of innovative formulations able to promote their localization in affected tissues while also decreasing the number of administrations required. This review describes the advantages deriving from the use of lipid- and polymer-based systems containing iTNF-α, focusing on their physicochemical and technological properties and discussing the preclinical results obtained in vivo using rodent models of colitis.

A real-world data analysis of ocular adverse events linked to anti-VEGF drugs: a WHO-VigiAccess study

Introduction

Vascular endothelial growth factor (VEGF) is key to wet age-related macular degeneration (wAMD). Anti-VEGF drugs are the main treatment in clinics. This study assessed ocular adverse events (AE) from anti-VEGF drugs in VigiAccess, WHO's database, and compared adverse drug reaction (ADR) profiles of four drugs to aid personalized treatment choices for optimal benefit and safety.

Methods

The design was a descriptive retrospective study. We observed four anti-VEGF drugs commonly used in the clinical treatment of wAMD, and their ADR reports came from WHO-VigiAccess. The collected data included the age group, gender, and regional data, as well as the data of disease systems and symptoms caused by ADR recorded in the annual ADR reports and reports received by the WHO. We observed the overall characteristics of the ADR reports of these drugs, then explored the distribution of 27 SOCs of these drugs. Subsequently, we compared the most common ocular ADRs of the drugs. Finally, we compared the commonalities and differences of ocular ADRs related to the drugs.

Results

Overall, 57,779 AE associated with the four anti-VEGF drugs were reported. The results showed that the number of females experiencing ADRs (67.83%) was significantly higher than males (32.17%), the age group with the highest reported incidence was over 75 years old. More than half of the ADR reports came from the Americas (50.86%). The five most common types of AE were: eye disorders (43.56%), general disorders and administration site conditions (34.47%), injury poisoning and procedural complications (13.36%), infections and infestations (11.61%), nervous system disorders (9.99%). Compared with the other three inhibitors, brolucizumab had a significantly higher rate of ocular ADR reports. The most common ocular ADRs of these four anti-VEGF drugs were mostly related to visual impairment, vision blurred, and blindness. However, there is still a disparity of ADRs between different drugs.

Conclusion

The presence of ocular AEs when using anti-VEGF drugs to treat wAMD in clinical practice should attract clinical attention. Clinicians should use these expensive drugs more rationally based on the characteristics of ADRs and develop personalized treatment plans for patients.

Characteristic analysis of adverse reactions of five anti-TNFɑ agents: a descriptive analysis from WHO-VigiAccess

Introduction: Tumor necrosis factor (TNF) inhibitors (adalimumab, infliximab, etanercept, golimumab, and certolizumab pegol) have revolutionized the treatment of severe immune-mediated inflammatory diseases, including rheumatoid arthritis, Crohn's disease, psoriatic arthritis, ankylosing spondylitis, and ulcerative colitis. This study assessed adverse drug reactions (ADRs) after the use of TNFα inhibitors in VigiAccess of the World Health Organization (WHO) and compared the adverse reaction characteristics of five inhibitors to select the drug with the least risk for individualized patient use. Methods: The study was a retrospective descriptive analysis method in design. We sorted out five marketed anti-TNFα drugs, and their ADR reports were obtained from WHO-VigiAccess. Data collection included data on the age groups, sex, and regions of patients worldwide covered by ADR reports, as well as data on disease systems and symptoms caused by ADRs recorded in annual ADR reports and reports received by the WHO. By calculating the proportion of adverse reactions reported for each drug, we compared the similarities and differences in adverse reactions for the five drugs. Results: Overall, 1,403,273 adverse events (AEs) related to the five anti-TNFα agents had been reported in VigiAccess at the time of the search. The results show that the 10 most commonly reported AE manifestations were rash, arthralgia, rheumatoid arthritis, headache, pneumonia, psoriasis, nausea, diarrhea, pruritus, and dyspnea. The top five commonly reported AE types of anti-TNFα drugs were as follows: infections and infestations (184,909, 23.0%), musculoskeletal and connective tissue disorders (704,657, 28.6%), gastrointestinal disorders (122,373, 15.3%), skin and subcutaneous tissue disorders (108,259, 13.5%), and nervous system disorders (88,498, 11.0%). The preferred terms of myelosuppression and acromegaly were obvious in golimumab. Infliximab showed a significantly higher ADR report ratio in the infusion-related reaction compared to the other four inhibitors. The rate of ADR reports for lower respiratory tract infection and other infections was the highest for golimumab. Conclusion: No causal associations could be established between the TNFα inhibitors and the ADRs. Current comparative observational studies of these inhibitors revealed common and specific adverse reactions in the ADR reports of the WHO received for these drugs. Clinicians should improve the rational use of these high-priced drugs according to the characteristics of ADRs.