Selected cutaneous adverse events in patients treated with ICI monotherapy and combination therapy: a retrospective pharmacovigilance study and meta-analysis
Introduction: Cutaneous adverse events are commonly reported immune-related adverse events (irAEs), some of which are serious or even life-threatening, and it is essential to study these specific cutaneous AEs to understand their characteristics and risk.Methods: We performed a meta-analysis of publ...
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| Format: | Article |
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Frontiers Media S.A.
2023-06-01
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| Series: | Frontiers in Pharmacology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fphar.2023.1076473/full |
| _version_ | 1797813723106115584 |
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| author | Wenchao Lu Huiyun Zhang Qixiang Guo Zhuoyue Gou Jiannan Yao |
| author_facet | Wenchao Lu Huiyun Zhang Qixiang Guo Zhuoyue Gou Jiannan Yao |
| author_sort | Wenchao Lu |
| collection | DOAJ |
| description | Introduction: Cutaneous adverse events are commonly reported immune-related adverse events (irAEs), some of which are serious or even life-threatening, and it is essential to study these specific cutaneous AEs to understand their characteristics and risk.Methods: We performed a meta-analysis of published clinical trials for immune checkpoint inhibitors (ICIs) to evaluate the incidence of cutaneous adverse events, using data from PubMed, Embase, and the Cochrane Library databases.Results: A total of 232 trials with 45,472 patients were involved. Results showed that anti-PD-1 and targeted therapy combinations were associated with higher risk for most of the selected cutaneous adverse events. In addition, a retrospective pharmacovigilance study was conducted using the Food and Drug Administration (FDA) Adverse Events System database. Reporting odds ratio (ROR) and Bayesian information components (IC) were used to perform the disproportionality analysis. Cases were extracted from January 2011 to September 2020. We identified 381 (20.24%) maculopapular rash, 213 (11.32%) vitiligo, 215 (11.42%) Stevens‐Johnson syndrome (SJS), and 165 (8.77%) toxic epidermal necrolysis (TEN) cases. For vitiligo, anti-PD-1/L1 combined with anti-CTLA-4 therapy showed the strongest signal (ROR: 55.89; 95% CI: 42.34–73.78; IC025: 4.73). Palmar-plantar erythrodysesthesia (PPE) was reported with the most significant association with combined anti-PD-1/L1 and VEGF (R)-TKIs (ROR: 18.67; 95% CI: 14.77–23.60; IC025: 3.67). For SJS/TEN, antiPD-1 inhibitors showed the strongest signal (ROR: 3.07; 95% CI: 2.68–3.52; IC025: 1.39). The median onset time of vitiligo and SJS/TEN was 83 and 24 days, respectively.Conclusion: Overall, in selected cutaneous AEs, each of them showed specific characteristics. It is necessary to realize their differences and take appropriate interventions in patients with different regimens. |
| first_indexed | 2024-03-13T07:56:01Z |
| format | Article |
| id | doaj.art-48daf8b71daf45359a1fad74489e811e |
| institution | Directory Open Access Journal |
| issn | 1663-9812 |
| language | English |
| last_indexed | 2024-03-13T07:56:01Z |
| publishDate | 2023-06-01 |
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| series | Frontiers in Pharmacology |
| spelling | doaj.art-48daf8b71daf45359a1fad74489e811e2023-06-02T04:28:05ZengFrontiers Media S.A.Frontiers in Pharmacology1663-98122023-06-011410.3389/fphar.2023.10764731076473Selected cutaneous adverse events in patients treated with ICI monotherapy and combination therapy: a retrospective pharmacovigilance study and meta-analysisWenchao Lu0Huiyun Zhang1Qixiang Guo2Zhuoyue Gou3Jiannan Yao4Department of Pharmacy, Beijing Chaoyang Hospital, Capital Medical University, Beijing, ChinaDepartment of Oncology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, ChinaDepartment of Pharmacy, Beijing Chaoyang Hospital, Capital Medical University, Beijing, ChinaInstitute for Drug Evaluation, Peking University Health Science Center, Beijing, ChinaDepartment of Oncology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, ChinaIntroduction: Cutaneous adverse events are commonly reported immune-related adverse events (irAEs), some of which are serious or even life-threatening, and it is essential to study these specific cutaneous AEs to understand their characteristics and risk.Methods: We performed a meta-analysis of published clinical trials for immune checkpoint inhibitors (ICIs) to evaluate the incidence of cutaneous adverse events, using data from PubMed, Embase, and the Cochrane Library databases.Results: A total of 232 trials with 45,472 patients were involved. Results showed that anti-PD-1 and targeted therapy combinations were associated with higher risk for most of the selected cutaneous adverse events. In addition, a retrospective pharmacovigilance study was conducted using the Food and Drug Administration (FDA) Adverse Events System database. Reporting odds ratio (ROR) and Bayesian information components (IC) were used to perform the disproportionality analysis. Cases were extracted from January 2011 to September 2020. We identified 381 (20.24%) maculopapular rash, 213 (11.32%) vitiligo, 215 (11.42%) Stevens‐Johnson syndrome (SJS), and 165 (8.77%) toxic epidermal necrolysis (TEN) cases. For vitiligo, anti-PD-1/L1 combined with anti-CTLA-4 therapy showed the strongest signal (ROR: 55.89; 95% CI: 42.34–73.78; IC025: 4.73). Palmar-plantar erythrodysesthesia (PPE) was reported with the most significant association with combined anti-PD-1/L1 and VEGF (R)-TKIs (ROR: 18.67; 95% CI: 14.77–23.60; IC025: 3.67). For SJS/TEN, antiPD-1 inhibitors showed the strongest signal (ROR: 3.07; 95% CI: 2.68–3.52; IC025: 1.39). The median onset time of vitiligo and SJS/TEN was 83 and 24 days, respectively.Conclusion: Overall, in selected cutaneous AEs, each of them showed specific characteristics. It is necessary to realize their differences and take appropriate interventions in patients with different regimens.https://www.frontiersin.org/articles/10.3389/fphar.2023.1076473/fullimmune checkpoint inhibitorscutaneous adverse eventsFAERS analysismeta-analysisprevalence |
| spellingShingle | Wenchao Lu Huiyun Zhang Qixiang Guo Zhuoyue Gou Jiannan Yao Selected cutaneous adverse events in patients treated with ICI monotherapy and combination therapy: a retrospective pharmacovigilance study and meta-analysis Frontiers in Pharmacology immune checkpoint inhibitors cutaneous adverse events FAERS analysis meta-analysis prevalence |
| title | Selected cutaneous adverse events in patients treated with ICI monotherapy and combination therapy: a retrospective pharmacovigilance study and meta-analysis |
| title_full | Selected cutaneous adverse events in patients treated with ICI monotherapy and combination therapy: a retrospective pharmacovigilance study and meta-analysis |
| title_fullStr | Selected cutaneous adverse events in patients treated with ICI monotherapy and combination therapy: a retrospective pharmacovigilance study and meta-analysis |
| title_full_unstemmed | Selected cutaneous adverse events in patients treated with ICI monotherapy and combination therapy: a retrospective pharmacovigilance study and meta-analysis |
| title_short | Selected cutaneous adverse events in patients treated with ICI monotherapy and combination therapy: a retrospective pharmacovigilance study and meta-analysis |
| title_sort | selected cutaneous adverse events in patients treated with ici monotherapy and combination therapy a retrospective pharmacovigilance study and meta analysis |
| topic | immune checkpoint inhibitors cutaneous adverse events FAERS analysis meta-analysis prevalence |
| url | https://www.frontiersin.org/articles/10.3389/fphar.2023.1076473/full |
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