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Cardiovascular toxicities associated with bispecific T-cell engager therapy

不良事件报告系统 不利影响 医学 内科学 食品药品监督管理局 药理学
作者
Ahmed Sayed,Malak Munir,Sanam M Ghazi,Maryam Ferdousi,Satyam Krishan,Adnan Shaaban,Alma Habib,Onaopepo Kola-Kehinde,Patrick Ruz,Sarah Khan,Sneha Sharma,Alexa Meara,Syed Mahmood,Stephanie Feldman,Eric H. Yang,Ji‐Won Kim,Narendranath Epperla,Daniel Addison
出处
期刊:Journal for ImmunoTherapy of Cancer [BMJ]
卷期号:12 (2): e008518-e008518 被引量:1
标识
DOI:10.1136/jitc-2023-008518
摘要

Background Bispecific T-cell engagers (BTEs) are novel agents used to treat hematological malignancies. Early trials were underpowered to define cardiovascular adverse events (CVAE) and no large-scale studies systematically examined the CVAEs associated with BTEs. Methods Leveraging the US Food and Drug Administration’s Adverse Event Reporting System-(FAERS), we identified the relative frequency of CVAEs after initiation of five BTE products approved by the Food and Drug Administration between 2014 and 2023 for the treatment of hematological malignancies. Adjusted reporting ORs (aROR) were used to identify disproportionate reporting of CVAEs with BTEs compared with background rates in the database. Fatality rates and risk ratios (RRs) for each adverse event (AE) were calculated. Results From 3668 BTE-related cases reported to FAERS, 747 (20.4%) involved CVAEs. BTEs as a class were associated with fatal CVAEs (aROR 1.29 (95% CI 1.12 to 1.50)), an association mainly driven by teclistamab (aROR 2.44 (95% CI 1.65 to 3.60)). Teclistamab was also associated with a disproportionate risk of myocarditis (aROR 25.70 (95% CI 9.54 to 69.23)) and shock (aROR 3.63 (95% CI 2.30 to 5.74)), whereas blinatumomab was associated with a disproportionate risk of disseminated intravascular coagulation (aROR 3.02 (95% CI 1.98 to 4.60)) and hypotension (aROR 1.59 (95% CI 1.25 to 2.03)). CVAEs were more fatal compared with non-CVAEs (31.1% vs 17.4%; RR 1.76 (95% CI 1.54 to 2.03)). Most CVAEs (83.3%) did not overlap with cytokine release syndrome. Conclusion In the first postmarketing surveillance study of BTEs, CVAEs were involved in approximately one in five AE reports and carried a significant mortality risk.
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