Real-World Safety of Ixekizumab: A Disproportionality Analysis Using the FDA Adverse Event Reporting System and the VigiAccess databases

Kaidi Zhao¹Xuanfeng Tan¹Miao Qin¹Qinxiao Li¹Meng QinQin²Ying Liu³Jing Li^4*JiaShu Liu^4*

• ¹Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
• ²Shanghai 6th Peoples Hospital Affiliated to Shanghai Jiao Tong University, Shanghai, China
• ³Honghui Hospital, Xi'an, China
• ⁴Xi'an Jiaotong University Affiliated Children's Hospital, Xi'an, China

Ixekizumab is a biologic agent primarily indicated for the treatment of moderate-to-severe plaque psoriasis. This study aimed to evaluate the post-marketing safety profile of ixekizumab by analyzing adverse event (AE) reports retrieved from the Food and Drug Administration Adverse Event Reporting System (FAERS) database and VigiAccess databases. Four disproportionality analysis methods were employed in this study to detect positive signals associated with ixekizumab, including Reporting Odds Ratio (ROR), Proportional Reporting Ratio (PRR), Bayesian Confidence Propagation Neural Network (BCPNN), and Multi-item Gamma Poisson Shrinker (MGPS). Sensitivity analyses were conducted to ensure the robustness of the findings. Additionally, the time to onset of AEs was further analyzed. In the FAERS databases and VigiAccess databases, 72847 AE reports in total. Commonly reported AEs included injection site reactions, hypersensitivity reactions, fungal infections, upper respiratory tract infections, and inflammatory bowel disease. In addition, several unexpected AEs were identified, such as cellulitis, ear infection, bronchitis, herpes zoster, tooth infection, diverticulitis, kidney infection, and gastroenteritis viral. Sensitivity analysis further confirmed the robustness of these findings. Notably, 41.1% of the AEs occurred within the first month after treatment initiation. This study confirmed several known AEs and identified some unexpected AEs, providing preliminary safety insights to guide clinicians in the safe use of ixekizumab in clinical practice. It is important to note that findings from spontaneous adverse event reporting systems are hypothesis-generating and may be limited by underreporting, variable reporting quality, and confounding factors.