Coagulation dysfunction events associated with tigecycline: a real-world study from FDA adverse event reporting system (FAERS) database

Mingxing Guo; Jinwei Liang; Dandan Li; Ying Zhao; Wanyi Xu; Lei Wang; Xiangli Cui

doi:10.1186/s12959-022-00369-z

Coagulation dysfunction events associated with tigecycline: a real-world study from FDA adverse event reporting system (FAERS) database

Thromb J. 2022 Mar 5;20(1):12. doi: 10.1186/s12959-022-00369-z.

Authors

Mingxing Guo¹, Jinwei Liang², Dandan Li¹, Ying Zhao¹, Wanyi Xu¹, Lei Wang³, Xiangli Cui⁴

Affiliations

¹ Department of Pharmacy, Beijing Friendship Hospital, Capital Medical University, Beijing, China.
² School of Automation Science and Electrical Engineering, Beihang University, Beijing, China.
³ School of Automation Science and Electrical Engineering, Beihang University, Beijing, China. lwang@buaa.edu.cn.
⁴ Department of Pharmacy, Beijing Friendship Hospital, Capital Medical University, Beijing, China. cui10@163.com.

Abstract

Background: Tigecycline has broad-spectrum anti-bacterial activity and often used for critically ill patients with complicated infections. Only a few clinical studies have reported the coagulation disorder induced by tigecycline. The aim of this study was to investigate the association between tigecycline and coagulation dysfunction using the US Food and Drug Administration Adverse Event Reporting System (FAERS) database.

Method: Data from January 2005 to December 2020 in FAERS were retrieved. We investigated the clinical characteristics of the coagulation dysfunction events and conducted disproportionality analysis by using reporting odds ratios (ROR) to compare tigecycline with the full database and other antibiotics.

Results: The total number of reports of coagulation dysfunction related to tigecycline as the primary suspect drug was 223. The median time to event of the coagulation dysfunction events was 10 (interquartile range [IQR] 6.75-13) days. 80.72% coagulation-related adverse events appeared within the first 14 days since the initiation of tigecycline administration. The overall ROR (95% CI) for coagulation-related adverse events was 3.55 (3.08, 4.09). The RORs (95% CI) for thrombocytopenia, hypofibrinogenaemia, coagulopathy, activated partial thromboplastin time prolonged, international normalized ratio increased, prothrombin time prolonged were 8.21 (6.34, 10.62), 705.41 (526.81, 944.54), 30.67 (21.92, 42.92), 42.98 (24.85, 74.31), 4.67 (2.51, 8.71), and 27.99 (15.01, 52.19), respectively. In analyses stratified on comparing tigecycline to vancomycin and daptomycin, significant coagulation dysfunction signals were found with the RORs (95% CI) 2.74 (2.34, 3.22) and 3.08 (2.57, 3.70).

Conclusions: We found a strong signal of high frequency of reporting coagulation dysfunction in tigecycline. Health professionals should be aware of the potential coagulation disorders risk and monitor coagulation parameters during anti-bacterial therapy with tigecycline, particularly the need to monitor fibrinogen levels.

Keywords: Coagulation dysfunction; FDA adverse event reporting system; Tigecycline.