Post-marketing safety concerns with palbociclib: a disproportionality analysis of the FDA adverse event reporting system

Expert Opin Drug Saf. 2024 May;23(5):637-648. doi: 10.1080/14740338.2024.2338247. Epub 2024 Apr 12.

Abstract

Objectives: To explore the association between palbociclib and related adverse events (AEs) in the real world through U.S. Food and Drug Administration Adverse Event Reporting System (FAERS) database.

Methods: The signal strength of palbociclib-related AEs was done by disproportionality analysis. Clinical priority of palbociclib-related AEs was scored and ranked by assessing five different features. Outcome analysis, time to onset analysis, dose-report /AEs number analysis, and stratification analysis were all performed.

Results: There were 61,821 'primary suspected (PS)' reports of palbociclib and 195,616 AEs associated with palbociclib. The four algorithms simultaneously detected 18 positive signals at the SOC level, and 65 positive signals at the PT level. Bone marrow failure, neuropathy, peripheral, pleural effusion, myelosuppression, pulmonary edema, and pulmonary thrombosis were also found to have positive signals. Gender (female vs male, χ2 = 5.287, p = 0.022) and age showed significant differences in serious and non-serious reports. Palbociclib-related AEs had a median onset time of 79 days (interquartile range [IQR] 20-264 days).

Conclusions: The study identified potential Palbociclib-related AEs and offered warnings for special AEs, providing further data for palbociclib safety studies in breast cancer patients. Nonetheless, prospective clinical trials are needed to validate these results and explain their relationship.

Keywords: Breast cancer; FAERS; data mining; palbociclib; pharmacovigilance.

MeSH terms

  • Adult
  • Adverse Drug Reaction Reporting Systems* / statistics & numerical data
  • Age Factors
  • Aged
  • Aged, 80 and over
  • Algorithms
  • Antineoplastic Agents* / administration & dosage
  • Antineoplastic Agents* / adverse effects
  • Databases, Factual*
  • Dose-Response Relationship, Drug
  • Female
  • Humans
  • Male
  • Middle Aged
  • Piperazines* / administration & dosage
  • Piperazines* / adverse effects
  • Product Surveillance, Postmarketing*
  • Protein Kinase Inhibitors / administration & dosage
  • Protein Kinase Inhibitors / adverse effects
  • Pyridines* / administration & dosage
  • Pyridines* / adverse effects
  • Sex Factors
  • Time Factors
  • United States
  • United States Food and Drug Administration*
  • Young Adult

Substances

  • palbociclib
  • Pyridines
  • Piperazines
  • Antineoplastic Agents
  • Protein Kinase Inhibitors