Adverse event profile of CGRP monoclonal antibodies: findings from the FDA adverse event reporting database

Expert Opin Drug Saf. 2024 Jan;23(1):107-117. doi: 10.1080/14740338.2023.2250720. Epub 2023 Sep 18.

Abstract

Background: Four CGRP Monoclonal Antibodies (mAbs) have been approved for migraine prophylaxis by the Food and Drug Administration (FDA) since 2018. However, there are concerns about the safety of these four drugs for real-world use.

Objective: To compare the adverse event profiles of four CGRP-mAbs with FAERS data.

Methods: The study was based on records from the FAERS database. Only reports containing one of the active ingredients with CGRP-mAbs were included in this study. Disproportionality analyses including but not limited to reporting odds ratio (ROR) and information components (IC) were conducted to identify drug-AE associations.

Results: In total, 58110 reports were identified for CGRP-mAbs. 80 overlapping signals were disproportionately reported. They affected a range of organs and systems, including the gastrointestinal and cardiovascular systems, skin, and hair. Additionally, the rare cardiovascular adverse events were significantly different among the four CGRP-mAbs.

Conclusion: We identified numerous shared underlying signals (overlapping signals) for CGRP-mAbs as suspected drugs in multiple systems and organs. The unlabeled common signals may indicate potential safety issues. In addition, the underlying safety signals varied among the four CGRP-mAbs, particularly in the cardiovascular system, and further studies are needed to confirm these associations and the potential clinical implications.

Keywords: CGRP; adverse event; disproportionality analyses; migraine; real world.

MeSH terms

  • Adverse Drug Reaction Reporting Systems
  • Antibodies, Monoclonal* / adverse effects
  • Calcitonin Gene-Related Peptide
  • Drug-Related Side Effects and Adverse Reactions*
  • Humans
  • United States
  • United States Food and Drug Administration

Substances

  • Antibodies, Monoclonal
  • Calcitonin Gene-Related Peptide