Real-world safety profile of elexacaftor/tezacaftor/ivacaftor: a disproportionality analysis using the U.S. FDA adverse event reporting system

BackgroundElexacaftor/Tezacaftor/Ivacaftor (ETI) has demonstrated significant efficacy in enhancing clinical outcomes for patients with cystic fibrosis (CF). Despite this, comprehensive post-marketing assessments of its adverse drug events (ADEs) remain insufficient. This study aims to analyze the A...

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Main Authors: Chengyu Zhu, Zhiwei Cui, Tingting Liu, Siyu Lou, Linmei Zhou, Junyou Chen, Ruizhen Zhao, Li Wang, Yingyong Ou, Fan Zou
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-03-01
Series:Frontiers in Pharmacology
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Online Access:https://www.frontiersin.org/articles/10.3389/fphar.2025.1531514/full
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author Chengyu Zhu
Zhiwei Cui
Tingting Liu
Siyu Lou
Linmei Zhou
Junyou Chen
Ruizhen Zhao
Li Wang
Yingyong Ou
Fan Zou
author_facet Chengyu Zhu
Zhiwei Cui
Tingting Liu
Siyu Lou
Linmei Zhou
Junyou Chen
Ruizhen Zhao
Li Wang
Yingyong Ou
Fan Zou
author_sort Chengyu Zhu
collection DOAJ
description BackgroundElexacaftor/Tezacaftor/Ivacaftor (ETI) has demonstrated significant efficacy in enhancing clinical outcomes for patients with cystic fibrosis (CF). Despite this, comprehensive post-marketing assessments of its adverse drug events (ADEs) remain insufficient. This study aims to analyze the ADEs associated with ETI using the U.S. FDA Adverse Event Reporting System (FAERS).MethodsWe conducted a pharmacovigilance analysis utilizing FAERS data from Q4 2019 to Q3 2024. Reports of ADEs related to ETI were extracted, and disproportionality analyses—including Reporting Odds Ratio (ROR), Proportional Reporting Ratio (PRR), Bayesian Confidence Propagation Neural Network (BCPNN), and Multi-item Gamma Poisson Shrinker (MGPS)—were employed to evaluate signal strength. Additionally, a time-to-onset (TTO) analysis was performed.ResultsA total of 28,366 ETI-related ADEs were identified, spanning 27 organ systems. We identified 322 positive signals, with signals consistent with the drug label including headache (702 cases, ROR 2.75), infective pulmonary exacerbation of CF (691 cases, ROR 384.24), rash (538 cases, ROR 2.72), and cough (507 cases, ROR 3.79). Unexpected signals were also noted, such as anxiety (494 cases, ROR 4.16), depression (364 cases, ROR 4.59), insomnia (281 cases ROR 2.83), nephrolithiasis (79 cases, ROR 3.63) and perinatal depression (4 cases, ROR 13.59). The TTO analysis indicated that the median onset of ADEs was 70 days, with 37.08% occurring within the first month. Subgroup analyses revealed that females exhibited a higher reporting rank for mental disorder and constipation, whereas in males, they were insomnia, abdominal pain, and nasopharyngitis.ConclusionThis study highlights both recognized and unexpected ADEs associated with ETI, underscoring the necessity for ongoing monitoring, particularly concerning psychiatric conditions. The subgroup analysis suggests a need for personalized treatment strategies to optimize patient care.
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spelling doaj-art-daf3994210724bcd9df3dda143e6f79f2025-08-20T02:47:50ZengFrontiers Media S.A.Frontiers in Pharmacology1663-98122025-03-011610.3389/fphar.2025.15315141531514Real-world safety profile of elexacaftor/tezacaftor/ivacaftor: a disproportionality analysis using the U.S. FDA adverse event reporting systemChengyu Zhu0Zhiwei Cui1Tingting Liu2Siyu Lou3Linmei Zhou4Junyou Chen5Ruizhen Zhao6Li Wang7Yingyong Ou8Fan Zou9Department of Respiratory and Critical Care Medicine, Affiliated Hospital of Zunyi Medical University, Zunyi, ChinaDepartment of Obstetrics and Gynecology, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, ChinaDepartment of Respiratory and Critical Care Medicine, Affiliated Hospital of Zunyi Medical University, Zunyi, ChinaDepartment of Respiratory and Critical Care Medicine, Affiliated Hospital of Zunyi Medical University, Zunyi, ChinaDepartment of Respiratory and Critical Care Medicine, Affiliated Hospital of Zunyi Medical University, Zunyi, ChinaDepartment of Respiratory and Critical Care Medicine, Affiliated Hospital of Zunyi Medical University, Zunyi, ChinaDepartment of Respiratory and Critical Care Medicine, Affiliated Hospital of Zunyi Medical University, Zunyi, ChinaDepartment of Respiratory and Critical Care Medicine, Affiliated Hospital of Zunyi Medical University, Zunyi, ChinaDepartment of Respiratory and Critical Care Medicine, Affiliated Hospital of Zunyi Medical University, Zunyi, ChinaDepartment of Respiratory and Critical Care Medicine, Affiliated Hospital of Zunyi Medical University, Zunyi, ChinaBackgroundElexacaftor/Tezacaftor/Ivacaftor (ETI) has demonstrated significant efficacy in enhancing clinical outcomes for patients with cystic fibrosis (CF). Despite this, comprehensive post-marketing assessments of its adverse drug events (ADEs) remain insufficient. This study aims to analyze the ADEs associated with ETI using the U.S. FDA Adverse Event Reporting System (FAERS).MethodsWe conducted a pharmacovigilance analysis utilizing FAERS data from Q4 2019 to Q3 2024. Reports of ADEs related to ETI were extracted, and disproportionality analyses—including Reporting Odds Ratio (ROR), Proportional Reporting Ratio (PRR), Bayesian Confidence Propagation Neural Network (BCPNN), and Multi-item Gamma Poisson Shrinker (MGPS)—were employed to evaluate signal strength. Additionally, a time-to-onset (TTO) analysis was performed.ResultsA total of 28,366 ETI-related ADEs were identified, spanning 27 organ systems. We identified 322 positive signals, with signals consistent with the drug label including headache (702 cases, ROR 2.75), infective pulmonary exacerbation of CF (691 cases, ROR 384.24), rash (538 cases, ROR 2.72), and cough (507 cases, ROR 3.79). Unexpected signals were also noted, such as anxiety (494 cases, ROR 4.16), depression (364 cases, ROR 4.59), insomnia (281 cases ROR 2.83), nephrolithiasis (79 cases, ROR 3.63) and perinatal depression (4 cases, ROR 13.59). The TTO analysis indicated that the median onset of ADEs was 70 days, with 37.08% occurring within the first month. Subgroup analyses revealed that females exhibited a higher reporting rank for mental disorder and constipation, whereas in males, they were insomnia, abdominal pain, and nasopharyngitis.ConclusionThis study highlights both recognized and unexpected ADEs associated with ETI, underscoring the necessity for ongoing monitoring, particularly concerning psychiatric conditions. The subgroup analysis suggests a need for personalized treatment strategies to optimize patient care.https://www.frontiersin.org/articles/10.3389/fphar.2025.1531514/fullCFTR modulatorpharmacovigilanceFAERSreal world analysisadverse drug events
spellingShingle Chengyu Zhu
Zhiwei Cui
Tingting Liu
Siyu Lou
Linmei Zhou
Junyou Chen
Ruizhen Zhao
Li Wang
Yingyong Ou
Fan Zou
Real-world safety profile of elexacaftor/tezacaftor/ivacaftor: a disproportionality analysis using the U.S. FDA adverse event reporting system
Frontiers in Pharmacology
CFTR modulator
pharmacovigilance
FAERS
real world analysis
adverse drug events
title Real-world safety profile of elexacaftor/tezacaftor/ivacaftor: a disproportionality analysis using the U.S. FDA adverse event reporting system
title_full Real-world safety profile of elexacaftor/tezacaftor/ivacaftor: a disproportionality analysis using the U.S. FDA adverse event reporting system
title_fullStr Real-world safety profile of elexacaftor/tezacaftor/ivacaftor: a disproportionality analysis using the U.S. FDA adverse event reporting system
title_full_unstemmed Real-world safety profile of elexacaftor/tezacaftor/ivacaftor: a disproportionality analysis using the U.S. FDA adverse event reporting system
title_short Real-world safety profile of elexacaftor/tezacaftor/ivacaftor: a disproportionality analysis using the U.S. FDA adverse event reporting system
title_sort real world safety profile of elexacaftor tezacaftor ivacaftor a disproportionality analysis using the u s fda adverse event reporting system
topic CFTR modulator
pharmacovigilance
FAERS
real world analysis
adverse drug events
url https://www.frontiersin.org/articles/10.3389/fphar.2025.1531514/full
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