Ocular adverse events associated with BRAF and MEK inhibitor combination therapy: a pharmacovigilance disproportionality analysis of the FDA adverse event reporting system

Expert Opin Drug Saf. 2023 Feb;22(2):175-181. doi: 10.1080/14740338.2023.2189235. Epub 2023 Mar 10.

Abstract

Background: BRAF and MEK inhibitor combination therapy have significantly improved the outcome of several BRAF-mutation tumors, but it also confers the risk of drug-induced ocular adverse events (oAEs). However, very few studies focused on this risk.

Methods: The United States Food and Drug Administration Adverse Event Reporting System (FAERS) data from Quarter 1-2011 to Quarter 2-2022 were searched to detect signs of oAEs of three marketed BRAF and MEK inhibitor combination therapies: vemurafenib plus cobimetinib (V + C), dabrafenib plus trametinib (D + T), and encorafenib plus binimetinib (E + B). Disproportionality analyses were performed by calculating the proportional reporting ratio (PRR), χ2 (chi-square), and reporting odds ratios (RORs) with a 95% confidence interval (CI).

Results: A series of oAEs were identified, including 42 preferred terms, which could be classified into 8 aspects. In addition to previously reported oAEs, several unexpected oAE signals were detected. Moreover, differences in oAE profiles were found among three combination therapies (V + C, D + T, and E + B).

Conclusions: Our findings support an association between several oAEs and BRAF and MEK inhibitor combination therapies, including several new oAEs. In addition, oAEs profiles may vary across the treatment regimens. Further studies are needed to better quantify these oAEs.

Keywords: Adverse event reporting system; BRAF and MEK inhibitor combination therapy; disproportionality analysis; ocular adverse events; pharmacovigilance.

MeSH terms

  • Antineoplastic Combined Chemotherapy Protocols / adverse effects
  • Humans
  • Melanoma* / drug therapy
  • Mitogen-Activated Protein Kinase Kinases
  • Pharmacovigilance
  • Protein Kinase Inhibitors / adverse effects
  • Proto-Oncogene Proteins B-raf / genetics
  • Skin Neoplasms* / drug therapy
  • Sulfonamides / adverse effects
  • United States

Substances

  • Proto-Oncogene Proteins B-raf
  • Sulfonamides
  • Protein Kinase Inhibitors
  • Mitogen-Activated Protein Kinase Kinases
  • BRAF protein, human