Safety of infliximab and adalimumab in pediatric inflammatory bowel diseases: a disproportionality analysis from the FAERS database

Abstract Background The incidence of pediatric inflammatory bowel disease (IBD) significantly increased recently. Infliximab (IFX) and adalimumab (ADA), both TNF-α inhibitors, are the only FDA-approved treatments for pediatric IBD. Due to the unique physiological and developmental characteristics of...

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Main Authors: Yanhong Deng, Shengying Shi, Senling Feng, Xiangping Tan, Yinling Wang, Jinjin Yin, Shaozhi Liu, Yuanmei Gao
Format: Article
Language:English
Published: BMC 2025-08-01
Series:BMC Gastroenterology
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Online Access:https://doi.org/10.1186/s12876-025-04154-w
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author Yanhong Deng
Shengying Shi
Senling Feng
Xiangping Tan
Yinling Wang
Jinjin Yin
Shaozhi Liu
Yuanmei Gao
author_facet Yanhong Deng
Shengying Shi
Senling Feng
Xiangping Tan
Yinling Wang
Jinjin Yin
Shaozhi Liu
Yuanmei Gao
author_sort Yanhong Deng
collection DOAJ
description Abstract Background The incidence of pediatric inflammatory bowel disease (IBD) significantly increased recently. Infliximab (IFX) and adalimumab (ADA), both TNF-α inhibitors, are the only FDA-approved treatments for pediatric IBD. Due to the unique physiological and developmental characteristics of children, postmarketing pharmacovigilance requires ongoing attention. We aimed to evaluate the safety of IFX and ADA in pediatric IBD using FAERS database data from Q1 2004 to Q1 2024. Methods Reporting Odds Ratio (ROR) and Proportional Reporting Ratio (PRR) algorithms were used to identify drug-related adverse events (AEs). Results In total, we retrieved 10,905 IFX-related reports and 5,446 ADA-related reports in pediatric IBD. Common AEs associated with IFX were infusion reactions; for ADA, they were injection site reactions. While most AEs align with approved labeling, continued vigilant monitoring appears important for specific postmarketing AEs observed with IFX, including suicide attempts, weight increased, and psoriasis. The median onset (TTO) for IFX-related AEs was 579 days (interquartile range [IQR]: 159.25–1357 days), occurring mostly after 360 days. For ADA, TTO was 79 days (IQR: 21.75–295 days), with most within 90 days of treatment initiation. Conclusion Our study revealed that although most AEs matched labeled information, rigorous post-marketing monitoring of severe AEs remains important for IFX and ADA in pediatric IBD, with additional confirmatory research warranted.
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spelling doaj-art-3a0c2b2632974a0eaef1d388eecf3aa22025-08-20T03:05:25ZengBMCBMC Gastroenterology1471-230X2025-08-0125111510.1186/s12876-025-04154-wSafety of infliximab and adalimumab in pediatric inflammatory bowel diseases: a disproportionality analysis from the FAERS databaseYanhong Deng0Shengying Shi1Senling Feng2Xiangping Tan3Yinling Wang4Jinjin Yin5Shaozhi Liu6Yuanmei Gao7Department of Pharmacy, Guangdong Provincial Key Laboratory of Major Obstetric Diseases, Guangdong Provincial Clinical Research Center for Obstetrics and Gynecology, The Third Affiliated Hospital of Guangzhou Medical UniversityDepartment of Pharmacy, Guangdong Provincial Key Laboratory of Major Obstetric Diseases, Guangdong Provincial Clinical Research Center for Obstetrics and Gynecology, The Third Affiliated Hospital of Guangzhou Medical UniversityDepartment of Pharmacy, Guangdong Provincial Key Laboratory of Major Obstetric Diseases, Guangdong Provincial Clinical Research Center for Obstetrics and Gynecology, The Third Affiliated Hospital of Guangzhou Medical UniversityDepartment of Pharmacy, Guangdong Provincial Key Laboratory of Major Obstetric Diseases, Guangdong Provincial Clinical Research Center for Obstetrics and Gynecology, The Third Affiliated Hospital of Guangzhou Medical UniversityDepartment of Critical Care Medicine, Guangdong Provincial Key Laboratory of Major Obstetric Diseases, Guangdong Provincial Clinical Research Center for Obstetrics and Gynecology, The Third Affiliated Hospital of Guangzhou Medical UniversityDepartment of Pharmacy, Guangdong Provincial Key Laboratory of Major Obstetric Diseases, Guangdong Provincial Clinical Research Center for Obstetrics and Gynecology, The Third Affiliated Hospital of Guangzhou Medical UniversityDepartment of Pharmacy, Guangdong Provincial Key Laboratory of Major Obstetric Diseases, Guangdong Provincial Clinical Research Center for Obstetrics and Gynecology, The Third Affiliated Hospital of Guangzhou Medical UniversityDepartment of Respiratory and Critical Care Medicine, Guangdong Provincial Key Laboratory of Major Obstetric Diseases, Guangdong Provincial Clinical Research Center for Obstetrics and Gynecology, The Third Affiliated Hospital of Guangzhou Medical UniversityAbstract Background The incidence of pediatric inflammatory bowel disease (IBD) significantly increased recently. Infliximab (IFX) and adalimumab (ADA), both TNF-α inhibitors, are the only FDA-approved treatments for pediatric IBD. Due to the unique physiological and developmental characteristics of children, postmarketing pharmacovigilance requires ongoing attention. We aimed to evaluate the safety of IFX and ADA in pediatric IBD using FAERS database data from Q1 2004 to Q1 2024. Methods Reporting Odds Ratio (ROR) and Proportional Reporting Ratio (PRR) algorithms were used to identify drug-related adverse events (AEs). Results In total, we retrieved 10,905 IFX-related reports and 5,446 ADA-related reports in pediatric IBD. Common AEs associated with IFX were infusion reactions; for ADA, they were injection site reactions. While most AEs align with approved labeling, continued vigilant monitoring appears important for specific postmarketing AEs observed with IFX, including suicide attempts, weight increased, and psoriasis. The median onset (TTO) for IFX-related AEs was 579 days (interquartile range [IQR]: 159.25–1357 days), occurring mostly after 360 days. For ADA, TTO was 79 days (IQR: 21.75–295 days), with most within 90 days of treatment initiation. Conclusion Our study revealed that although most AEs matched labeled information, rigorous post-marketing monitoring of severe AEs remains important for IFX and ADA in pediatric IBD, with additional confirmatory research warranted.https://doi.org/10.1186/s12876-025-04154-wInfliximabAdalimumabAdverse eventPharmacovigilancePediatricInflammatory bowel diseases
spellingShingle Yanhong Deng
Shengying Shi
Senling Feng
Xiangping Tan
Yinling Wang
Jinjin Yin
Shaozhi Liu
Yuanmei Gao
Safety of infliximab and adalimumab in pediatric inflammatory bowel diseases: a disproportionality analysis from the FAERS database
BMC Gastroenterology
Infliximab
Adalimumab
Adverse event
Pharmacovigilance
Pediatric
Inflammatory bowel diseases
title Safety of infliximab and adalimumab in pediatric inflammatory bowel diseases: a disproportionality analysis from the FAERS database
title_full Safety of infliximab and adalimumab in pediatric inflammatory bowel diseases: a disproportionality analysis from the FAERS database
title_fullStr Safety of infliximab and adalimumab in pediatric inflammatory bowel diseases: a disproportionality analysis from the FAERS database
title_full_unstemmed Safety of infliximab and adalimumab in pediatric inflammatory bowel diseases: a disproportionality analysis from the FAERS database
title_short Safety of infliximab and adalimumab in pediatric inflammatory bowel diseases: a disproportionality analysis from the FAERS database
title_sort safety of infliximab and adalimumab in pediatric inflammatory bowel diseases a disproportionality analysis from the faers database
topic Infliximab
Adalimumab
Adverse event
Pharmacovigilance
Pediatric
Inflammatory bowel diseases
url https://doi.org/10.1186/s12876-025-04154-w
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