Safety profiles of IDH inhibitors: a pharmacovigilance analysis of the FDA Adverse Event Reporting System (FAERS) database

Abstract Background With the increased use of isocitrate dehydrogenase (IDH) inhibitors in acute myeloid leukemia (AML) and cholangiocarcinoma, the toxicity of these drugs is a growing concern. This study aimed to evaluate the adverse events (AEs) of IDH inhibitors based on the Food and Drug Adminis...

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Main Authors: Ximu Sun, Han Zhou, Yanming Li, Yanhui Luo, Qixiang Guo, Yixin Sun, Chenguang Jia, Bin Wang, Maoquan Qin, Peng Guo
Format: Article
Language:English
Published: SpringerOpen 2025-02-01
Series:Future Journal of Pharmaceutical Sciences
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Online Access:https://doi.org/10.1186/s43094-025-00769-8
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author Ximu Sun
Han Zhou
Yanming Li
Yanhui Luo
Qixiang Guo
Yixin Sun
Chenguang Jia
Bin Wang
Maoquan Qin
Peng Guo
author_facet Ximu Sun
Han Zhou
Yanming Li
Yanhui Luo
Qixiang Guo
Yixin Sun
Chenguang Jia
Bin Wang
Maoquan Qin
Peng Guo
author_sort Ximu Sun
collection DOAJ
description Abstract Background With the increased use of isocitrate dehydrogenase (IDH) inhibitors in acute myeloid leukemia (AML) and cholangiocarcinoma, the toxicity of these drugs is a growing concern. This study aimed to evaluate the adverse events (AEs) of IDH inhibitors based on the Food and Drug Administration Adverse Event Reporting System (FAERS) database. Methods AE reports for IDH inhibitors (enasidenib, ivosidenib, and olutasidenib) were collected and analyzed from the time of launch through the first quarter of 2024. Only IDH inhibitors reported as the target drug and coded as the primary suspect (PS) were included in the analysis. AEs were standardized and classified according to the preferred term (PT) and system organ classification (SOC) in the Medical Dictionary for Regulatory Activities (MedDRA) version 26.0. Disproportionality analyses including the reporting odds ratio and the Bayesian confidence propagation neural network were performed in data mining to assess IDH inhibitor-relatedAEs. Differentiation syndrome was the AE of special interest. Results The reports number of enasidenib, ivosidenib, and olutasidenib was 11 616 357, 10 067 250, and 2 563 464, respectively. A total of 80 enasidenib-related signals involving 15 SOCs, 78 ivosidenib-related signals involving 17 SOCs, and 7 olutasidenib-related signals involving 4 SOCs were obtained. The most signals reported were “blood and lymphatic system disorders,” “infections and infestations,” and “nervous system disorders” in enasidenib. For signals of ivosidenib, the most frequently reported were “gastrointestinal disorders,” “general disorders and administration site conditions,” and “injury, poisoning and procedural complications.” Ivosidenib was the only IDH inhibitor with signals in “cardiac disorders.” Differentiation syndrome events were reported in 89, 40, and 2 cases for enasidenib, ivosidenib, and olutasidenib, respectively. The median time to onset was 26–31 days for ivosidenib and enasidenib. AML was the most common indication in the differentiation syndrome reports. Conclusions Our study identifies potential AE signals associated with IDH inhibitors and provides a broader understanding of the safety. The safety profiles highlight the need for long-term safety monitoring of IDH inhibitor recipients. Promptly monitoring and intervention in specific organ systems depending on the type of IDH inhibitor may improve the overall survival or enhance the quality of life. In the future, it will be necessary to validate our findings in prospective large-scale studies and to investigate the underlying mechanisms.
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spelling doaj-art-7cf8e751a5e442c5afc990ab7cf0cb772025-02-09T12:16:17ZengSpringerOpenFuture Journal of Pharmaceutical Sciences2314-72532025-02-0111111210.1186/s43094-025-00769-8Safety profiles of IDH inhibitors: a pharmacovigilance analysis of the FDA Adverse Event Reporting System (FAERS) databaseXimu Sun0Han Zhou1Yanming Li2Yanhui Luo3Qixiang Guo4Yixin Sun5Chenguang Jia6Bin Wang7Maoquan Qin8Peng Guo9Department of Pharmacy, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s HealthDepartment of Pharmacy, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s HealthDepartment of Pharmacy, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s HealthDepartment of Stem Cell Transplantation, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s HealthSchool of Pharmaceutical Sciences, Tsinghua UniversityDepartment of Pharmacy, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s HealthDepartment of Stem Cell Transplantation, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s HealthDepartment of Stem Cell Transplantation, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s HealthDepartment of Stem Cell Transplantation, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s HealthDepartment of Pharmacy, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s HealthAbstract Background With the increased use of isocitrate dehydrogenase (IDH) inhibitors in acute myeloid leukemia (AML) and cholangiocarcinoma, the toxicity of these drugs is a growing concern. This study aimed to evaluate the adverse events (AEs) of IDH inhibitors based on the Food and Drug Administration Adverse Event Reporting System (FAERS) database. Methods AE reports for IDH inhibitors (enasidenib, ivosidenib, and olutasidenib) were collected and analyzed from the time of launch through the first quarter of 2024. Only IDH inhibitors reported as the target drug and coded as the primary suspect (PS) were included in the analysis. AEs were standardized and classified according to the preferred term (PT) and system organ classification (SOC) in the Medical Dictionary for Regulatory Activities (MedDRA) version 26.0. Disproportionality analyses including the reporting odds ratio and the Bayesian confidence propagation neural network were performed in data mining to assess IDH inhibitor-relatedAEs. Differentiation syndrome was the AE of special interest. Results The reports number of enasidenib, ivosidenib, and olutasidenib was 11 616 357, 10 067 250, and 2 563 464, respectively. A total of 80 enasidenib-related signals involving 15 SOCs, 78 ivosidenib-related signals involving 17 SOCs, and 7 olutasidenib-related signals involving 4 SOCs were obtained. The most signals reported were “blood and lymphatic system disorders,” “infections and infestations,” and “nervous system disorders” in enasidenib. For signals of ivosidenib, the most frequently reported were “gastrointestinal disorders,” “general disorders and administration site conditions,” and “injury, poisoning and procedural complications.” Ivosidenib was the only IDH inhibitor with signals in “cardiac disorders.” Differentiation syndrome events were reported in 89, 40, and 2 cases for enasidenib, ivosidenib, and olutasidenib, respectively. The median time to onset was 26–31 days for ivosidenib and enasidenib. AML was the most common indication in the differentiation syndrome reports. Conclusions Our study identifies potential AE signals associated with IDH inhibitors and provides a broader understanding of the safety. The safety profiles highlight the need for long-term safety monitoring of IDH inhibitor recipients. Promptly monitoring and intervention in specific organ systems depending on the type of IDH inhibitor may improve the overall survival or enhance the quality of life. In the future, it will be necessary to validate our findings in prospective large-scale studies and to investigate the underlying mechanisms.https://doi.org/10.1186/s43094-025-00769-8IDH inhibitorsEnasidenibIvosidenibOlutasidenibFAERSPharmacovigilance
spellingShingle Ximu Sun
Han Zhou
Yanming Li
Yanhui Luo
Qixiang Guo
Yixin Sun
Chenguang Jia
Bin Wang
Maoquan Qin
Peng Guo
Safety profiles of IDH inhibitors: a pharmacovigilance analysis of the FDA Adverse Event Reporting System (FAERS) database
Future Journal of Pharmaceutical Sciences
IDH inhibitors
Enasidenib
Ivosidenib
Olutasidenib
FAERS
Pharmacovigilance
title Safety profiles of IDH inhibitors: a pharmacovigilance analysis of the FDA Adverse Event Reporting System (FAERS) database
title_full Safety profiles of IDH inhibitors: a pharmacovigilance analysis of the FDA Adverse Event Reporting System (FAERS) database
title_fullStr Safety profiles of IDH inhibitors: a pharmacovigilance analysis of the FDA Adverse Event Reporting System (FAERS) database
title_full_unstemmed Safety profiles of IDH inhibitors: a pharmacovigilance analysis of the FDA Adverse Event Reporting System (FAERS) database
title_short Safety profiles of IDH inhibitors: a pharmacovigilance analysis of the FDA Adverse Event Reporting System (FAERS) database
title_sort safety profiles of idh inhibitors a pharmacovigilance analysis of the fda adverse event reporting system faers database
topic IDH inhibitors
Enasidenib
Ivosidenib
Olutasidenib
FAERS
Pharmacovigilance
url https://doi.org/10.1186/s43094-025-00769-8
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