Comparison of thrombotic adverse events in patients treated with factor VIII products and emicizumab using the 2018-2022 US Food and Drug Administration Adverse Event Reporting System data.

J Thromb Haemost

Department of Research and Development, GC Biopharma, Yongin, South Korea; Department of Biohealth Regulatory Science, Sungkyunkwan University, Suwon, South Korea. Electronic address:

Published: June 2024

AI Article Synopsis

  • A study investigated the frequency of thrombotic adverse events (AEs) associated with emicizumab compared to factor VIII (FVIII) products, using data from the FDA Adverse Event Reporting System.
  • Results from 2018-2022 showed that thrombotic AEs were reported about 3 times more frequently for emicizumab, with 4.07% of reports compared to 1.44% for FVIII products.
  • The study suggests a need for further research to monitor and understand the risks of thrombotic AEs in the use of emicizumab for hemophilia therapy.

Article Abstract

Background: Relatively little is known about thrombotic adverse events (AEs) of emicizumab in postmarketing real-world settings, particularly in comparison with factor VIII (FVIII) products. A recent European study reported a potentially greater thrombotic risk of emicizumab compared with FVIII products.

Objectives: This drug safety study aims to investigate whether thrombotic AEs are more frequently reported for emicizumab than for FVIII products and if so, whether it is independent of bypassing agents as coreporting drugs using the United States Food and Drug Administration Adverse Event Reporting System data.

Methods: Disproportionality analyses for thrombotic AEs of emicizumab vs FVIII products were conducted. Three signal detection indicators were used: proportional reporting ratio (PRR), reporting odds ratio (ROR), and informational component (IC).

Results: During 2018-2022, the proportions of thrombotic AEs among all AEs were 4.07% (97 out of 2383) and 1.44% (134 out of 9324) for emicizumab and FVIII products, respectively: PRR = 2.83 (2.19-3.66), ROR = 2.91 (2.23-3.79), and IC = 1.04 (0.70-1.28). Bypassing agents as coreporting drugs were identified in 36% and 15% of the total thrombotic AE reports associated with emicizumab and FVIII products, respectively. Even after thrombotic AE reports with bypassing agents were excluded, the reporting proportion of thrombotic AEs was still greater for emicizumab than for FVIII products: PRR = 2.19 (1.60-2.99).

Conclusion: Thrombotic AEs in the United States Food and Drug Administration Adverse Event Reporting System data were about 3 times more frequently reported for emicizumab than for FVIII products. More research and efforts in the future are warranted for monitoring, elucidating, and preventing the potential risk of thrombotic AEs in hemophilia therapy, including emicizumab.

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http://dx.doi.org/10.1016/j.jtha.2024.02.009DOI Listing

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