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- Title
Severe cutaneous adverse reactions associated with the immune checkpoint inhibitors: A case/non‐case analysis using the Food and Drug Administration Adverse Event Reporting System.
- Authors
Godfrey, Hannah; Jedlowski, Patrick; Thiede, Rebecca
- Abstract
Background/Objectives: The immune checkpoint inhibitors (ICIs) have been increasingly associated with severe cutaneous adverse reactions (SCARs). These reactions, including Stevens–Johnson syndrome (SJS), toxic epidermal necrolysis (TEN), drug reaction with eosinophilia and systemic symptoms (DRESS) and acute generalized exanthematous pustulosis (AGEP) are uncommon but potentially lethal. Despite the severity of these reactions and growing association with the ICIs, their specific risk and mortality rates have been largely unexplored. Methods: A case/non‐case analysis was performed using data from the United States Food and Drug Administration (FDA) Adverse Event Reporting System (FAERS) to examine the reporting odds ratios (RORs) for ICI‐associated SCARs cases under two conditions: (1) ICIs compared with all drugs in FAERS and (2) ICIs compared with a reference group of pooled anticancer drugs to control for underlying malignancy. Results: A statistically significant ROR for SJS (ROR: 5.44), TEN (ROR: 5.81) and DRESS (ROR: 1.38) were identified under Condition 1. Under Condition 2, this significance was maintained for SJS (ROR: 7.31), TEN (ROR: 7.40) and DRESS (ROR: 3.90), and mild significance was identified for AGEP (ROR: 1.89). Mortality rates for the ICIs were increased compared with the anticancer medications (28.5% vs. 24.5% for SJS, 55.3% vs. 46% for TEN, 3.0% vs. 2.1% for AGEP and 7.1% vs. 6.1% for DRESS). Conclusions: Our results suggest an association between SCARs and the ICIs independent of cancer status.
- Subjects
UNITED States. Food &; Drug Administration; IMMUNE checkpoint inhibitors; FOOD chemistry; TOXIC epidermal necrolysis; DRUG eruptions; ANTINEOPLASTIC agents; IPILIMUMAB; STEVENS-Johnson Syndrome
- Publication
Australasian Journal of Dermatology, 2024, Vol 65, Issue 3, p243
- ISSN
0004-8380
- Publication type
Article
- DOI
10.1111/ajd.14262