Safety of Adalimumab: An Analysis of the FDA Adverse Event Reporting System (FAERS) Database

Authors

  • Buthainah Ghanem Department of Pharmaceutical Economics and Policy, School of Pharmacy, Chapman University, Irvine, CA, USA.

DOI:

https://doi.org/10.35516/jjps.v16i3.629

Keywords:

Adalimumab, Serious adverse events, FAERS database, Rheumatology, Humira

Abstract

Objective: This study aims to assess the safety profile of adalimumab and its biosimilars for each approved indication by analyzing adverse events (AEs) reported in the FDA Adverse Event Reporting System (FAERS) database.

Method: We conducted a retrospective pharmacovigilance analysis of AE reports documented from 2002 to 2022 in the FAERS database. This analysis included descriptive statistics and binary logistic regression analyses. We calculated reporting odds ratios (RORs) with 95% confidence intervals (CI) to investigate safety signals related to the disproportionate reporting of serious AEs for adalimumab and its biosimilars compared to currently available biological products for the same proposed indications.

Results: A total of 543,873 AEs related to adalimumab treatment were reported, with 49.8% classified as serious. Hospitalization was the most frequently reported AE. Risk factors associated with serious AEs included age (≥60 years), male sex, and the concurrent use of adalimumab (ROR >1, P<0.05). Adalimumab exhibited a lower risk of serious AEs compared to abatacept, certolizumab, infliximab, or rituximab. Conversely, etanercept and ixekizumab showed lower odds of serious AEs than adalimumab (ROR <1, P<0.05).

Conclusion: In summary, these findings suggest that adalimumab has a well-tolerated safety profile for approved indications when compared to currently available biological alternatives. 

Author Biography

Buthainah Ghanem, Department of Pharmaceutical Economics and Policy, School of Pharmacy, Chapman University, Irvine, CA, USA.

Department of Pharmaceutical Economics and Policy, School of Pharmacy, Chapman University, Irvine, CA, USA.

References

Bain B, Brazil M. Adalimumab. Nat Rev Drug Discov. 2003;2(9):693-694. doi:10.1038/nrd1182 DOI: https://doi.org/10.1038/nrd1182

Zhao S, Chadwick L, Mysler E, Moots RJ. Review of Biosimilar Trials and Data on Adalimumab in Rheumatoid Arthritis. Curr Rheumatol Rep. 2018;20(10):57. Published 2018 Aug 9. doi:10.1007/s11926-018-0769-6 DOI: https://doi.org/10.1007/s11926-018-0769-6

Barut K, Adrovic A, Şahin S, Kasapçopur Ö. Juvenile Idiopathic Arthritis. Balkan Med J. 2017;34(2):90-101. doi:10.4274/balkanmedj.2017.0111 DOI: https://doi.org/10.4274/balkanmedj.2017.0111

Salvarani C, Pipitone N, Catanoso M, et al. Adalimumab in psoriatic arthritis. J Rheumatol Suppl. 2012;89:77-81. doi:10.3899/jrheum.120251 DOI: https://doi.org/10.3899/jrheum.120251

van der Heijde D, Kivitz A, Schiff MH, et al. Efficacy and safety of adalimumab in patients with ankylosing spondylitis: results of a multicenter, randomized, double-blind, placebo-controlled trial. Arthritis Rheum. 2006;54(7):2136-2146. doi:10.1002/art.21913 DOI: https://doi.org/10.1002/art.21913

Serghini M, Haddad W, Jeddi H, et al. Indications et résultats de l'adalimumab au cours de la maladie de Crohn [Efficacy and safety of Adalimumab in Crohn's disease]. Tunis Med. 2012;90(2):101-107.

Sandborn WJ, van Assche G, Reinisch W, et al. Adalimumab induces and maintains clinical remission in patients with moderate-to-severe ulcerative colitis. Gastroenterology. 2012;142(2):257-65.e653. doi:10.1053/j.gastro.2011.10.032 DOI: https://doi.org/10.1053/j.gastro.2011.10.032

Croom KF, McCormack PL. Adalimumab: in plaque psoriasis. Am J Clin Dermatol. 2009;10(1):43-50. doi:10.2165/0128071-200910010-00008 DOI: https://doi.org/10.2165/0128071-200910010-00008

Kim ES, Garnock-Jones KP, Keam SJ. Adalimumab: A Review in Hidradenitis Suppurativa. Am J Clin Dermatol. 2016;17(5):545-552. doi:10.1007/s40257-016-0220-6 DOI: https://doi.org/10.1007/s40257-016-0220-6

LaMattina KC, Goldstein DA. Adalimumab for the treatment of uveitis. Expert Rev Clin Immunol. 2017;13(3):181-188. doi:10.1080/1744666X.2017.1288097 DOI: https://doi.org/10.1080/1744666X.2017.1288097

Lu X, Hu R, Peng L, Liu M, Sun Z. Efficacy and Safety of Adalimumab Biosimilars: Current Critical Clinical Data in Rheumatoid Arthritis. Front Immunol. 2021;12:638444. Published 2021 Apr 6. doi:10.3389/fimmu.2021.638444 DOI: https://doi.org/10.3389/fimmu.2021.638444

Nanau RM, Neuman MG. Safety of anti-tumor necrosis factor therapies in arthritis patients. J Pharm Pharm Sci. 2014;17(3):324-361. doi:10.18433/j3wp4f DOI: https://doi.org/10.18433/J3WP4F

Burmester GR, Panaccione R, Gordon KB, McIlraith MJ, Lacerda AP. Adalimumab: long-term safety in 23 458 patients from global clinical trials in rheumatoid arthritis, juvenile idiopathic arthritis, ankylosing spondylitis, psoriatic arthritis, psoriasis and Crohn's disease. Ann Rheum Dis. 2013;72(4):517-524. doi:10.1136/annrheumdis-2011-201244 DOI: https://doi.org/10.1136/annrheumdis-2011-201244

Burmester GR, Lin Y, Patel R, et al. Efficacy and safety of sarilumab monotherapy versus adalimumab monotherapy for the treatment of patients with active rheumatoid arthritis (MONARCH): a randomised, double-blind, parallel-group phase III trial. Ann Rheum Dis. 2017;76(5):840-847. doi:10.1136/annrheumdis-2016-210310 DOI: https://doi.org/10.1136/annrheumdis-2016-210310

Goettel AM, DeClercq J, Choi L, Graham TB, Mitchell AA. Efficacy and Safety of Abatacept, Adalimumab, and Etanercept in Pediatric Patients With Juvenile Idiopathic Arthritis. J Pediatr Pharmacol Ther. 2021;26(2):157-162. doi:10.5863/1551-6776-26.2.157 DOI: https://doi.org/10.5863/1551-6776-26.2.157

Mease PJ, Smolen JS, Behrens F, et al. A head-to-head comparison of the efficacy and safety of ixekizumab and adalimumab in biological-naïve patients with active psoriatic arthritis: 24-week results of a randomised, open-label, blinded-assessor trial. Ann Rheum Dis. 2020;79(1):123-131. doi:10.1136/annrheumdis-2019-215386 DOI: https://doi.org/10.1136/annrheumdis-2019-215386

Plosker GL, Lyseng-Williamson KA. Adalimumab: in Crohn's disease. BioDrugs. 2007;21(2):125-134. doi:10.2165/00063030-200721020-00007 DOI: https://doi.org/10.2165/00063030-200721020-00007

Ogata H, Hagiwara T, Kawaberi T, Kobayashi M, Hibi T. Safety and effectiveness of adalimumab in the treatment of ulcerative colitis: results from a large-scale, prospective, multicenter, observational study. Intest Res. 2021;19(4):419-429. doi:10.5217/ir.2020.00033 DOI: https://doi.org/10.5217/ir.2020.00033

Warren RB, Blauvelt A, Bagel J, et al. Bimekizumab versus Adalimumab in Plaque Psoriasis. N Engl J Med. 2021;385(2):130-141. doi:10.1056/NEJMoa2102388 DOI: https://doi.org/10.1056/NEJMoa2102388

Lu JW, Huang YW, Chen TL. Efficacy and safety of adalimumab in hidradenitis suppurativa: A systematic review and meta-analysis of randomized controlled trials. Medicine (Baltimore). 2021;100(22):e26190. doi:10.1097/MD.0000000000026190 DOI: https://doi.org/10.1097/MD.0000000000026190

Suhler EB, Jaffe GJ, Fortin E, et al. Long-Term Safety and Efficacy of Adalimumab in Patients with Noninfectious Intermediate Uveitis, Posterior Uveitis, or Panuveitis. Ophthalmology. 2021;128(6):899-909. doi:10.1016/j.ophtha.2020.10.036 DOI: https://doi.org/10.1016/j.ophtha.2020.10.036

FDA Adverse Event Reporting System (FAERS) Public Dashboard. Available at

https://www.fda.gov/drugs/questions-and-answers-fdas-adverse-event-reporting-system-faers/fda-adverse-event-reporting-system-faers-public-dashboard. Accessed June 15, 2022.

Purple Book: Lists of Licensed Biological Products with Reference Product Exclusivity and Biosimilarity or Interchangeability Evaluations. Available at: https://www.fda.gov/drugs/therapeutic-biologics-applications-bla/purple-book-lists-licensed-biological-products-reference-product-exclusivity-and-biosimilarity-or. Accessed June 15, 2022.

Gerriets V, Goyal A, Khaddour K. Tumor Necrosis Factor Inhibitors. In: StatPearls. Treasure Island (FL): StatPearls Publishing; April 30, 2022.

Leonardi C, Papp K, Strober B, et al. The long-term safety of adalimumab treatment in moderate to severe psoriasis: a comprehensive analysis of all adalimumab exposure in all clinical trials. Am J Clin Dermatol. 2011;12(5):321-337. doi:10.2165/11587890-000000000-00000 DOI: https://doi.org/10.2165/11587890-000000000-00000

van Vollenhoven RF. Sex differences in rheumatoid arthritis: more than meets the eye... BMC Med. 2009;7:12. Published 2009 Mar 30. doi:10.1186/1741-7015-7-12 DOI: https://doi.org/10.1186/1741-7015-7-12

Cross RK, Chiorean M, Vekeman F, Xiao Y, Wu E, Chao J, et al. (2019) Assessment of the real-world safety profile of vedolizumab using the United States Food and Drug Administration adverse event reporting system. PLoS ONE 14(12): e0225572.

https://doi.org/10.1371/journal.pone.0225572 DOI: https://doi.org/10.1371/journal.pone.0225572

Araujo AGS, Borba HHL, Tonin FS, et al. Safety of Biologics Approved for the Treatment of Rheumatoid Arthritis and Other Autoimmune Diseases: A Disproportionality Analysis from the FDA Adverse Event Reporting System (FAERS). BioDrugs. 2018;32(4):377-390. doi:10.1007/s40259-018-0285-2 DOI: https://doi.org/10.1007/s40259-018-0285-2

Nurminen M. To use or not to use the odds ratio in epidemiologic analyses?. Eur J Epidemiol. 1995;11(4):365-371. doi:10.1007/BF01721219 DOI: https://doi.org/10.1007/BF01721219

Tanni, K.A., Truong, C.B., Almahasis, S. et al. Safety of Marketed Cancer Supportive Care Biosimilars in the US: A Disproportionality Analysis Using the Food and Drug Administration Adverse Event Reporting System (FAERS) Database. BioDrugs 35, 239–254 (2021). https://doi.org/10.1007/s40259-020-00466-3 DOI: https://doi.org/10.1007/s40259-020-00466-3

Hakooz, N. (2023). Pharmacogenetics and Personalized Medicines . Jordan Journal of Pharmaceutical Sciences, 16(2), 444.

https://doi.org/10.35516/jjps.v16i2.1483 DOI: https://doi.org/10.35516/jjps.v16i2.1483

Hjazeen, R. (2023). Community Pharmacists’ Perspectives toward Continuing Professional Development: A Qualitative Study. Jordan Journal of Pharmaceutical Sciences, 16(2), 449. https://doi.org/10.35516/jjps.v16i2.1488 DOI: https://doi.org/10.35516/jjps.v16i2.1488

Alabbadi, I., Al-Oweidi, A. K. ., Daher, A., BaniHani, A., & Awidi, A. (2023). Hemophilia in Jordan: An Economic Burden Dilemma of Rare Disease. Jordan Journal of Pharmaceutical Sciences, 16(2), 356–367. https://doi.org/10.35516/jjps.v16i2.1462 DOI: https://doi.org/10.35516/jjps.v16i2.1462

Downloads

Published

2023-09-23

How to Cite

Ghanem, B. (2023). Safety of Adalimumab: An Analysis of the FDA Adverse Event Reporting System (FAERS) Database. Jordan Journal of Pharmaceutical Sciences, 16(3), 517–528. https://doi.org/10.35516/jjps.v16i3.629

Issue

Section

Articles