Pharmacovigilance and signal detection of adverse drug events associated with proteasome inhibitors in multiple myeloma: a real-world analysis using the FAERS database

Background Proteasome inhibitors (PIs) such as Bortezomib, Carfilzomib, and Ixazomib have significantly improved outcomes in multiple myeloma (MM), but their real-world safety profiles require further exploration.Objective To assess adverse drug events (ADEs) associated with Bortezomib, Carfilzomib,...

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Main Authors: JunYun Luo, Shupeng Chen, Meiling Zhang, Yao Gao, Yingjian Zeng
Format: Article
Language:English
Published: Taylor & Francis Group 2025-12-01
Series:Hematology
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Online Access:https://www.tandfonline.com/doi/10.1080/16078454.2025.2534758
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author JunYun Luo
Shupeng Chen
Meiling Zhang
Yao Gao
Yingjian Zeng
author_facet JunYun Luo
Shupeng Chen
Meiling Zhang
Yao Gao
Yingjian Zeng
author_sort JunYun Luo
collection DOAJ
description Background Proteasome inhibitors (PIs) such as Bortezomib, Carfilzomib, and Ixazomib have significantly improved outcomes in multiple myeloma (MM), but their real-world safety profiles require further exploration.Objective To assess adverse drug events (ADEs) associated with Bortezomib, Carfilzomib, and Ixazomib in MM patients using the FDA Adverse Event Reporting System (FAERS), and to identify new ADE signals not listed in product labels.Methods A total of 47,310 ADE reports (Bortezomib: 23,843; Carfilzomib: 9,835; Ixazomib: 13,632) were analyzed from FAERS (2004 – Q4 2024). Signal detection was conducted using Reporting Odds Ratio (ROR), Proportional Reporting Ratio (PRR), Bayesian Confidence Propagation Neural Network (BCPNN), and Multi-item Gamma Poisson Shrinker (MGPS). Onset time was evaluated using Weibull survival analysis.Results All three PIs were associated with significant ADE signals across multiple system organ classes, notably in the hematologic, nervous, cardiovascular, hepatobiliary, and gastrointestinal systems. Newly identified ADEs included muscular weakness (Bortezomib), pancytopenia (Carfilzomib), and cognitive disorder (Ixazomib). Onset time analysis showed that most ADEs occurred within the first 30 days of treatment.Conclusion This study highlights both known and newly detected ADEs linked to PIs, emphasizing the importance of early-phase monitoring and ongoing pharmacovigilance. The findings provide crucial real-world evidence for clinical risk management and future label updates.
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spelling doaj-art-ee5d7169daf841978dfa7f78be52bdfe2025-08-20T03:51:30ZengTaylor & Francis GroupHematology1607-84542025-12-0130110.1080/16078454.2025.2534758Pharmacovigilance and signal detection of adverse drug events associated with proteasome inhibitors in multiple myeloma: a real-world analysis using the FAERS databaseJunYun Luo0Shupeng Chen1Meiling Zhang2Yao Gao3Yingjian Zeng4School of Clinical Medicine, Jiangxi University of Chinese Medicine, Nanchang, People’s Republic of ChinaSchool of Clinical Medicine, Jiangxi University of Chinese Medicine, Nanchang, People’s Republic of ChinaSchool of Clinical Medicine, Jiangxi University of Chinese Medicine, Nanchang, People’s Republic of ChinaSchool of Clinical Medicine, Jiangxi University of Chinese Medicine, Nanchang, People’s Republic of ChinaAffiliated Hospital of Jiangxi University of Traditional Chinese Medicine, Nanchang, People’s Republic of ChinaBackground Proteasome inhibitors (PIs) such as Bortezomib, Carfilzomib, and Ixazomib have significantly improved outcomes in multiple myeloma (MM), but their real-world safety profiles require further exploration.Objective To assess adverse drug events (ADEs) associated with Bortezomib, Carfilzomib, and Ixazomib in MM patients using the FDA Adverse Event Reporting System (FAERS), and to identify new ADE signals not listed in product labels.Methods A total of 47,310 ADE reports (Bortezomib: 23,843; Carfilzomib: 9,835; Ixazomib: 13,632) were analyzed from FAERS (2004 – Q4 2024). Signal detection was conducted using Reporting Odds Ratio (ROR), Proportional Reporting Ratio (PRR), Bayesian Confidence Propagation Neural Network (BCPNN), and Multi-item Gamma Poisson Shrinker (MGPS). Onset time was evaluated using Weibull survival analysis.Results All three PIs were associated with significant ADE signals across multiple system organ classes, notably in the hematologic, nervous, cardiovascular, hepatobiliary, and gastrointestinal systems. Newly identified ADEs included muscular weakness (Bortezomib), pancytopenia (Carfilzomib), and cognitive disorder (Ixazomib). Onset time analysis showed that most ADEs occurred within the first 30 days of treatment.Conclusion This study highlights both known and newly detected ADEs linked to PIs, emphasizing the importance of early-phase monitoring and ongoing pharmacovigilance. The findings provide crucial real-world evidence for clinical risk management and future label updates.https://www.tandfonline.com/doi/10.1080/16078454.2025.2534758Multiple myelomaproteasome inhibitorsadverse drug eventsFAERSPharmacovigilanceonset time
spellingShingle JunYun Luo
Shupeng Chen
Meiling Zhang
Yao Gao
Yingjian Zeng
Pharmacovigilance and signal detection of adverse drug events associated with proteasome inhibitors in multiple myeloma: a real-world analysis using the FAERS database
Hematology
Multiple myeloma
proteasome inhibitors
adverse drug events
FAERS
Pharmacovigilance
onset time
title Pharmacovigilance and signal detection of adverse drug events associated with proteasome inhibitors in multiple myeloma: a real-world analysis using the FAERS database
title_full Pharmacovigilance and signal detection of adverse drug events associated with proteasome inhibitors in multiple myeloma: a real-world analysis using the FAERS database
title_fullStr Pharmacovigilance and signal detection of adverse drug events associated with proteasome inhibitors in multiple myeloma: a real-world analysis using the FAERS database
title_full_unstemmed Pharmacovigilance and signal detection of adverse drug events associated with proteasome inhibitors in multiple myeloma: a real-world analysis using the FAERS database
title_short Pharmacovigilance and signal detection of adverse drug events associated with proteasome inhibitors in multiple myeloma: a real-world analysis using the FAERS database
title_sort pharmacovigilance and signal detection of adverse drug events associated with proteasome inhibitors in multiple myeloma a real world analysis using the faers database
topic Multiple myeloma
proteasome inhibitors
adverse drug events
FAERS
Pharmacovigilance
onset time
url https://www.tandfonline.com/doi/10.1080/16078454.2025.2534758
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