Safety profile of belatacept in a real-life setting: disproportionality analysis of the WHO pharmacovigilance database
Abstract Background Belatacept is a co-stimulation blocker used in kidney transplant recipients to prevent allograft rejection. Unlike calcineurin inhibitors, belatacept is non-nephrotoxic and may carry a lower risk of cardiovascular and metabolic complications. However, the European Medicines Agenc...
Saved in:
| Main Authors: | , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2025-08-01
|
| Series: | BMC Pharmacology and Toxicology |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s40360-025-00972-6 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849341665055080448 |
|---|---|
| author | Alexandre O. Gérard Diane Merino Nouha Ben Othman Alexandre Destere Delphine Viard Elliot Ewig Fanny Rocher Antoine Sicard Milou-Daniel Drici |
| author_facet | Alexandre O. Gérard Diane Merino Nouha Ben Othman Alexandre Destere Delphine Viard Elliot Ewig Fanny Rocher Antoine Sicard Milou-Daniel Drici |
| author_sort | Alexandre O. Gérard |
| collection | DOAJ |
| description | Abstract Background Belatacept is a co-stimulation blocker used in kidney transplant recipients to prevent allograft rejection. Unlike calcineurin inhibitors, belatacept is non-nephrotoxic and may carry a lower risk of cardiovascular and metabolic complications. However, the European Medicines Agency (EMA) Summary of Product Characteristics (SmPC) includes a broad range of adverse drug reactions (ADRs), mostly identified in small clinical trials with cyclosporine as a control, in patients exposed to other immunosuppressants. As real-world data on belatacept safety accumulate, a reassessment of its safety profile becomes essential. Methods We analyzed pharmacovigilance data from VigiBase®, the World Health Organization global safety database, to explore discrepancies between postmarketing ADR reports and the belatacept Summary of Product Characteristics (SmPC). A disproportionality analysis was performed using the Information Component, a Bayesian metric, to identify potential pharmacovigilance signals. Results We retrieved 2795 reports involving belatacept, including 424 (15.2%) fatal cases. The disproportionality analysis highlighted 51 potential signals that were not explicitly listed in the SmPC, such as Clostridium difficile infection, hepatitis B reactivation, and hemophagocytic lymphohistiocytosis. Conversely, 47 (33.1%) of the 142 ADRs classified as “common” or “very common” in the SmPC, such as Cushing’s syndrome or depression, had fewer than three reports in VigiBase®. Conclusions This study highlights discrepancies between the belatacept SmPC and real-world pharmacovigilance data. Several labeled ADRs were not reported frequently in VigiBase®, suggesting that they may be less commonly observed in real-world settings. Others, particularly infections, warrant further scrutiny. Yet, these findings should be interpreted with caution due to the inherent limitations of pharmacovigilance data, including underreporting, reporting bias, and residual confounding. Pharmacovigilance approaches generate signals, but cannot definitively establish or exclude a causal relationship. Nonetheless, these findings suggest the need for periodic reassessment of belatacept’s safety profile to ensure accurate and clinically relevant information for healthcare providers. |
| format | Article |
| id | doaj-art-935e7a6ce87746c4af8d9ebb00bcc6a6 |
| institution | Kabale University |
| issn | 2050-6511 |
| language | English |
| publishDate | 2025-08-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Pharmacology and Toxicology |
| spelling | doaj-art-935e7a6ce87746c4af8d9ebb00bcc6a62025-08-20T03:43:34ZengBMCBMC Pharmacology and Toxicology2050-65112025-08-012611910.1186/s40360-025-00972-6Safety profile of belatacept in a real-life setting: disproportionality analysis of the WHO pharmacovigilance databaseAlexandre O. Gérard0Diane Merino1Nouha Ben Othman2Alexandre Destere3Delphine Viard4Elliot Ewig5Fanny Rocher6Antoine Sicard7Milou-Daniel Drici8Department of Nephrology-Dialysis-Transplantation, Université Côte d’Azur, University Hospital Centre of NiceDepartment of Clinical Pharmacology, Université Côte d’Azur, University Hospital Centre of NiceDepartment of Clinical Pharmacology, Université Côte d’Azur, University Hospital Centre of NiceDepartment of Clinical Pharmacology, Université Côte d’Azur, University Hospital Centre of NiceDepartment of Clinical Pharmacology, Université Côte d’Azur, University Hospital Centre of NiceDepartment of Clinical Pharmacology, Université Côte d’Azur, University Hospital Centre of NiceDepartment of Clinical Pharmacology, Université Côte d’Azur, University Hospital Centre of NiceDepartment of Nephrology-Dialysis-Transplantation, Université Côte d’Azur, University Hospital Centre of NiceDepartment of Clinical Pharmacology, Université Côte d’Azur, University Hospital Centre of NiceAbstract Background Belatacept is a co-stimulation blocker used in kidney transplant recipients to prevent allograft rejection. Unlike calcineurin inhibitors, belatacept is non-nephrotoxic and may carry a lower risk of cardiovascular and metabolic complications. However, the European Medicines Agency (EMA) Summary of Product Characteristics (SmPC) includes a broad range of adverse drug reactions (ADRs), mostly identified in small clinical trials with cyclosporine as a control, in patients exposed to other immunosuppressants. As real-world data on belatacept safety accumulate, a reassessment of its safety profile becomes essential. Methods We analyzed pharmacovigilance data from VigiBase®, the World Health Organization global safety database, to explore discrepancies between postmarketing ADR reports and the belatacept Summary of Product Characteristics (SmPC). A disproportionality analysis was performed using the Information Component, a Bayesian metric, to identify potential pharmacovigilance signals. Results We retrieved 2795 reports involving belatacept, including 424 (15.2%) fatal cases. The disproportionality analysis highlighted 51 potential signals that were not explicitly listed in the SmPC, such as Clostridium difficile infection, hepatitis B reactivation, and hemophagocytic lymphohistiocytosis. Conversely, 47 (33.1%) of the 142 ADRs classified as “common” or “very common” in the SmPC, such as Cushing’s syndrome or depression, had fewer than three reports in VigiBase®. Conclusions This study highlights discrepancies between the belatacept SmPC and real-world pharmacovigilance data. Several labeled ADRs were not reported frequently in VigiBase®, suggesting that they may be less commonly observed in real-world settings. Others, particularly infections, warrant further scrutiny. Yet, these findings should be interpreted with caution due to the inherent limitations of pharmacovigilance data, including underreporting, reporting bias, and residual confounding. Pharmacovigilance approaches generate signals, but cannot definitively establish or exclude a causal relationship. Nonetheless, these findings suggest the need for periodic reassessment of belatacept’s safety profile to ensure accurate and clinically relevant information for healthcare providers.https://doi.org/10.1186/s40360-025-00972-6BelataceptTransplantationImmunosuppressionAdverse drug reactionsPharmacovigilance |
| spellingShingle | Alexandre O. Gérard Diane Merino Nouha Ben Othman Alexandre Destere Delphine Viard Elliot Ewig Fanny Rocher Antoine Sicard Milou-Daniel Drici Safety profile of belatacept in a real-life setting: disproportionality analysis of the WHO pharmacovigilance database BMC Pharmacology and Toxicology Belatacept Transplantation Immunosuppression Adverse drug reactions Pharmacovigilance |
| title | Safety profile of belatacept in a real-life setting: disproportionality analysis of the WHO pharmacovigilance database |
| title_full | Safety profile of belatacept in a real-life setting: disproportionality analysis of the WHO pharmacovigilance database |
| title_fullStr | Safety profile of belatacept in a real-life setting: disproportionality analysis of the WHO pharmacovigilance database |
| title_full_unstemmed | Safety profile of belatacept in a real-life setting: disproportionality analysis of the WHO pharmacovigilance database |
| title_short | Safety profile of belatacept in a real-life setting: disproportionality analysis of the WHO pharmacovigilance database |
| title_sort | safety profile of belatacept in a real life setting disproportionality analysis of the who pharmacovigilance database |
| topic | Belatacept Transplantation Immunosuppression Adverse drug reactions Pharmacovigilance |
| url | https://doi.org/10.1186/s40360-025-00972-6 |
| work_keys_str_mv | AT alexandreogerard safetyprofileofbelataceptinareallifesettingdisproportionalityanalysisofthewhopharmacovigilancedatabase AT dianemerino safetyprofileofbelataceptinareallifesettingdisproportionalityanalysisofthewhopharmacovigilancedatabase AT nouhabenothman safetyprofileofbelataceptinareallifesettingdisproportionalityanalysisofthewhopharmacovigilancedatabase AT alexandredestere safetyprofileofbelataceptinareallifesettingdisproportionalityanalysisofthewhopharmacovigilancedatabase AT delphineviard safetyprofileofbelataceptinareallifesettingdisproportionalityanalysisofthewhopharmacovigilancedatabase AT elliotewig safetyprofileofbelataceptinareallifesettingdisproportionalityanalysisofthewhopharmacovigilancedatabase AT fannyrocher safetyprofileofbelataceptinareallifesettingdisproportionalityanalysisofthewhopharmacovigilancedatabase AT antoinesicard safetyprofileofbelataceptinareallifesettingdisproportionalityanalysisofthewhopharmacovigilancedatabase AT miloudanieldrici safetyprofileofbelataceptinareallifesettingdisproportionalityanalysisofthewhopharmacovigilancedatabase |