Safety Profile of Epidermal Growth Factor Receptor Tyrosine Kinase Inhibitors: A Disproportionality Analysis of FDA Adverse Event Reporting System

Sci Rep. 2020 Mar 16;10(1):4803. doi: 10.1038/s41598-020-61571-5.

Abstract

Adverse event reports submitted to the US Food and Drug Administration (FDA) were analyzed to map the safety profile of epidermal growth factor receptor-tyrosine kinase inhibitors (EGFR-TKIs). We conducted a disproportionality analysis of the adverse events (AEs) of EGFR-TKIs (gefitinib, erlotinib, afatinib, osimertinib) by data mining using the FDA adverse event reporting system (AERS) database, and by calculating the reporting odds ratios (ROR) with 95% confidence intervals. The FDA AERS database contained 27,123 EGFR-TKI-associated AERs within the reporting period from January 1, 2004 to March 31, 2018. Thirty-three preferred terms (PTs) were selected for analysis, and significant RORs were most commonly observed in the skin, nail, gastrointestinal tract, hepatic, eyes, and lungs. Unexpected adverse drug reactions were found in the "intestinal obstruction" and "hypokalaemia" in gefitinib and erlotinib, "hyponatraemia" in gefitinib, erlotinib and afatinib, "alopecia"in erlotinib, "hair growth abnormal" in afatinib, but not in "nausea" and "vomiting" listed on drug labels. The results of this study are consistent with clinical observation, suggesting the usefulness of pharmacovigilance research should be corroborated with the real-world FAERS data.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acrylamides / adverse effects*
  • Adverse Drug Reaction Reporting Systems*
  • Afatinib / adverse effects*
  • Aniline Compounds / adverse effects*
  • Data Mining
  • Databases, Factual
  • Drug-Related Side Effects and Adverse Reactions / etiology*
  • ErbB Receptors / antagonists & inhibitors*
  • Erlotinib Hydrochloride / adverse effects*
  • Gefitinib / adverse effects*
  • Humans
  • Pharmacovigilance*
  • Protein Kinase Inhibitors / adverse effects*
  • Protein-Tyrosine Kinases / antagonists & inhibitors*
  • Safety
  • United States
  • United States Food and Drug Administration

Substances

  • Acrylamides
  • Aniline Compounds
  • Protein Kinase Inhibitors
  • osimertinib
  • Afatinib
  • Erlotinib Hydrochloride
  • ErbB Receptors
  • Protein-Tyrosine Kinases
  • Gefitinib