Data-mining of cardiovascular adverse events signals for cyclin-dependent kinase 4/6 inhibitors based on FDA Adverse Event Reporting System database
Objective To detect cardiovascular adverse events(AEs)signals of cyclin-dependent kinase 4/6(CDK4/6)inhibitors,using the U.S.FDA Adverse Event Reporting System(FAERS)database,and to provide reference for clinically safe use of drugs.Methods Based on the FAERS database,adverse events(AE)reports about cardiovascular related to palbociclib,ribociclib,and abemaciclib were collected from 2015 to 2023.Cardiovascular AE was grouped into nine narrow categories using the Standardized Medical Dictionary for Regulatory Activities(MedDRA)Queries(SMQ).The AE signals were mined and analyzed with reporting odds ratio(ROR).Results A total of 7571 reports of cardiovascular AE related to CDK4/6 inhibitors were collected,including 4437 reports for palbociclib,2450 reports for ribociclib,and 684 reports for abemaciclib,involving 6417 patients.Based on SMQ,palbociclib did not detect positive signal,while ribociclib detected positive signal for cardiac arrhythmias(ROR=2.32,95%CI:2.17 to 2.47)and QT prolongation(ROR=6.14,95%CI:5.75 to 6.77),and abemaciclib detected embolic(ROR=1.63,95%CI:1.49 to 1.78)and thrombotic events.At the preferred terms level,all 3 kinds of CDK4/6 inhibitors caused positive signals for thrombosis,pulmonary embolism,and pulmonary oedema.Conclusion The clinical features and intensity of cardiovascular AE were different among CDK4/6 inhibitors.Clinicians must fully assess the patient's physiological status before using CDK4/6 inhibitors,and conduct individualized drug selection and monitoring according to the characteristics of drug AE.