Publications by authors named "Alexandre Joachim"

Objectives: Limited information is available on the safety of a rechallenge with an immune checkpoint inhibitor (ICI) after occurrence of an immune-related adverse event (irAE). We aim to identify potential emergent safety signals.

Design: This is an update of our observational pharmacovigilance cohort study.

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Objectives: Proton pump inhibitor (PPI) exposure can lead to hyponatraemia, which is a common cause of delirium. An association between PPI exposure and delirium without hyponatraemia has been suggested in the literature. We aimed to describe the association between reports of delirium and PPI exposure and to assess the association between PPI and delirium with and without hyponatraemia.

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  • The study investigates whether ibrutinib-related atrial fibrillation (IRAF) is linked to the dosage of ibrutinib, and if IRAF cases should lead to dosage adjustments or discontinuation of the drug.
  • Researchers analyzed data from the World Health Organization's VigiBase® pharmacovigilance database, focusing on 1,162 IRAF cases and various dosing regimens of ibrutinib (ranging from 140 mg/day to over 560 mg/day).
  • Results indicated that there was no significant association between the reported IRAF cases and the dosage of ibrutinib (p=0.09), suggesting IRAF is not a dose-dependent adverse drug reaction.
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Recent research suggests that fetal exposure to antidepressants (ADs) is significantly associated with fetal death, including stillbirth. However, there has been limited investigation into the timing of AD exposure during pregnancy, the specific effect of each drug, and the possibility of indication bias. To address these gaps in knowledge, we conducted a systematic review of literature and disproportionality analyses using the WHO Safety Database (VigiBase).

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  • Immune-checkpoint inhibitors (ICIs) can lead to serious heart issues like myocarditis, which can also involve broader muscle-related symptoms, highlighting the need for understanding associated risks.
  • A study conducted across 17 countries from 2014 to 2023 examined data from 748 patients to identify factors that predict severe outcomes related to these heart complications, using a statistical model for analysis.
  • Key findings indicated that certain conditions (like active thymoma) and symptoms (like low heart function) significantly increased the risk of severe heart-related events, and a risk score created from these factors effectively predicted outcomes, validated in multiple cohorts.
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  • This study reviews the risk of arterial hypertension in patients using poly (ADP-ribose) polymerase inhibitors (PARPi) based on data from randomized controlled trials (RCTs).
  • In analyzing 41 RCTs with over 15,000 patients, it was found that while olaparib was associated with a lower hypertension risk compared to placebo, niraparib significantly increased the risk of hypertension. The incidence was reported at about 19.87%.
  • The findings highlight the importance of monitoring for hypertension when using niraparib to ensure the therapeutic benefits are maintained, especially given that 66% of hypertension cases in real life were serious.
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  • * Research shows that patients with thymic epithelial tumors (TET), especially thymoma, experience ICI-related myotoxicities more frequently and with greater severity than those with other cancers.
  • * The presence of anti-acetylcholine-receptor antibodies suggests a link between thymic-related autoimmune responses and ICI myotoxicities, indicating that assessing the thymus could help predict these serious side effects in patients undergoing ICI therapy.
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Clozapine is primarily reserved for treatment-resistant schizophrenia due to safety concerns associated with its use. Infections have been reported with clozapine, which may lead to elevated serum levels of the drug. However, the existing literature on this topic is limited.

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  • The study investigates the risk of coronary artery disease (CAD) in prostate cancer patients requiring androgen deprivation therapy (ADT), highlighting the lack of clear guidelines for cardiology referrals.
  • A systematic cardio-onco evaluation at the Western Cancer Institute found that 20.6% of evaluated patients were newly diagnosed with CAD, often while being asymptomatic.
  • The results suggest a significant need for CAD screening in this patient group, as more than half of those evaluated required therapeutic interventions without any recorded cardiac deaths during the follow-up period.
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Due to their negative effects on hypoxic pulmonary vasoconstriction, dihydropyridine calcium channel inhibitors (DCCIs) can lead to hypoxia in patients with a pulmonary shunt. To date, only preclinical studies and case reports have focused on this potential adverse drug reaction. We aimed to assess the reporting association between DCCIs and hypoxia using the World Health Organization pharmacovigilance database (VigiBase).

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To investigate whether marital status is associated to long-term major fatal and non-fatal cardiovascular events in men and women from the Gubbio Population Study. The incidence of cardiovascular disease (CVD), including stroke and coronary heart disease (CHD) and CVD death together with all-cause mortality were analyzed. The analysis included 2832 persons (44% men, 54 ± 11 years old).

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  • The study aimed to evaluate the incidence of atrial fibrillation (AF) linked to 19 anticancer drugs used alone in clinical trials, focusing on how common AF is among cancer patients receiving these treatments.
  • Researchers analyzed 191 clinical trials involving 16 anticancer drugs and found that AF rates varied from 0.26 to 4.92 cases per 100 person-years, with the highest rates associated with ibrutinib, clofarabine, and ponatinib.
  • The findings highlight that AF is a significant concern in patients undergoing treatment with these drugs, suggesting the need for better monitoring procedures in clinical trials for drugs known to cause higher AF rates.
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Purpose: While statins and antiplatelet therapies are largely prescribed together worldwide, limited information is available on the safety of their association regarding rhabdomyolysis occurrence. We aimed to assess the reporting of rhabdomyolysis in patients treated with a combination of statin and antiplatelet therapy, compared to statin alone.

Methods: We used the World Health Organization pharmacovigilance database (VigiBase®) to compare the rhabdomyolysis reporting between statin (atorvastatin, fluvastatin, pravastatin, rosuvastatin, and simvastatin) plus antiplatelet therapy (acetylsalicylic acid, clopidogrel, prasugrel and ticagrelor) groups versus statin alone groups, for each statin and antiplatelet therapy.

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Background: Checkpoint inhibitors, such as PD-1 inhibitors (nivolumab, pembrolizumab) and anti-CTLA-4 (CD152) (ipilimumab), are widely used in metastatic melanoma, and most immune-related adverse events are known. Several cardiovascular AEs (CVAEs) associated with immune checkpoint inhibitor exposure have been reported in post-marketing surveillance studies and represent major issues for patients with melanoma during and after cancer treatment. Data on CVAES induced by immune checkpoint inhibitors in melanoma, especially incidence and risk factors, are lacking.

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Introduction: In order to reduce the under-reporting of adverse drug reactions (ADR) in general practice, the Caen Normandie regional pharmacovigilance center (CRPV) has implemented a training program for the French health insurance representatives (DAM) of the Manche department in order to raise awareness among general practitioners (GPs) to ADR reporting.

Purpose Of Research: During quarterly visits of DAM to GPs, the mode of operation and the value of pharmacovigilance reporting was presented. This pilot study presents the impact of these DAM visits to GPs in term of ADRs reporting quantification.

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Active cancer is associated with an increased risk of atrial fibrillation (AF), which varies depending on the pre-existing substrate (particularly in older patients), the cancer type and stage, and the anticancer therapeutics being taken. To date, studies have not been able to identify the individual contribution of each factor. During anticancer drug therapy, AF may occur with a frequency of ≈ 15-20% according to several factors, including the patient's baseline cardiovascular toxicity risk and the AF-detection strategies used.

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Background: The prescription of antidepressant drugs during pregnancy has been steadily increasing for several decades. Meta-analyses (MAs), which increase the statistical power and precision of results, have gained interest for assessing the safety of antidepressant drugs during pregnancy.

Objective: We aimed to provide a meta-review of MAs assessing the benefits and risks of antidepressant drug use during pregnancy.

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Introduction: Acquired hemophilia A (AHA) is a rare autoimmune hemorrhagic disease occurring in several underlying conditions. Drug-associated AHA (D-AHA) is poorly addressed nowadays.

Aim: This work aims to identify and characterize which drugs are associated with AHA using the WHO global database of reported potential effects of medicinal products (VigiBase).

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The association between COVID-19 vaccines and vasovagal malaise (VVM) has recently been reported in the literature. Our study aimed to describe COVID-19 vaccines associated VVM cases and to identify risk factors of COVID-19 vaccines associated VVM. To this end, we performed a descriptive study of VVM reports associated with COVID-19 vaccines from two French mass COVID-19 vaccination centers.

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  • - Transverse myelitis (TM) has been linked to the Janssen/Johnson & Johnson SARS-CoV-2 vaccine, but the relationship with other vaccines like Pfizer, Moderna, AstraZeneca, and Novavax is unclear, prompting this study to explore these associations.
  • - The research analyzed safety reports from the WHO's VigiBase, focusing on TM cases occurring within 28 days after receiving any FDA or EMA approved SARS-CoV-2 vaccine between December 2020 and March 2022.
  • - Results indicated a significant association between both mRNA-based and vector-based vaccines and TM, yet TM is still rare (0.28 cases per million doses), suggesting the overall benefits of vaccination outweigh the risks
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