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S979 A Nationwide Comparison of Ozanimod and Upadacitinib Adverse Events in Ulcerative Colitis Patients: A Pharmacovigilance Investigation

2023· article· en· W4387733501 on OpenAlexaff
Yash P. Ashara, Clive J. Miranda, Farhan Azad, Gregory D. Gudleski, Bhavtosh Dedania

Bibliographic record

VenueThe American Journal of Gastroenterology · 2023
Typearticle
Languageen
FieldImmunology and Microbiology
TopicBiosimilars and Bioanalytical Methods
Canadian institutionsBrandon University
Fundersnot available
KeywordsMedicineAdverse Event Reporting SystemInternal medicineAdverse effectUlcerative colitisOdds ratioPharmacovigilance

Abstract

fetched live from OpenAlex

Introduction: In the past decade, new biologics emerged for the treatment of ulcerative colitis (UC). Limited head-to-head trials of efficacy and safety profiles are available for these medications. Currently, the treatment of UC with biologics often stems from opinion-based algorithms, insurance coverage, and the clinical experience of gastroenterologists. In this study, we analyze a nationwide patient cohort in establishing a stratified safety profile with respect to ozanimod and upadacitinib. Methods: The US Food and Drug Administration’s Adverse Event Reports System (FAERS) data is a quarterly updated database which was queried primarily for ozanimod and upadacitinib in UC on February 5, 2023. The adverse events of infection and infestations, vascular, neuromusculoskeletal and skin with subcutaneous disorders were selectively considered to compare for the desired drugs. Analysis was performed using reported odds ratios (ROR) with 95% confidence interval (CI) and statistical significance P < 0.05. Results: A dataset of 768 adverse event cases were reported with ozanimod and upadacitinib in UC. 358 (46.6%) patients were male. There was no significant difference between rates of hospitalization between both drugs. Patients treated with ozanimod had significantly reduced risk of infectious complications compared to those patients being treated with upadacitinib [RR 0.52, 95% CI 0.38-0.73, P < 0.001] with common infections being nasopharyngitis, pneumonia, Clostridioides difficile gastroenteritis, urinary tract infection and sinusitis. However, patients treated with ozanimod had a significantly higher risk of vascular adverse events compared to those treated with upadacitinib [RR 5.38, 95% CI 2.00-14.50, P < 0.001] with hemorrhage being highest. Risk of neuromusculoskeletal complications is higher with ozanimod compared to those on upadacitinib [RR 1.43, 95% CI 1.07-1.92, P < 0.05] with most common events of headache, dizziness, back pain, and arthralgia. In addition, there was a significantly reduced risk of skin and subcutaneous tissue adverse reactions in patients on ozanimod compared to those on upadacitinib [RR 0.33, 95% CI 0.21-0.52, P < 0.001]. Incorporating gender and age did not yield any statistical significance. Conclusion: Compared to UC patients being treated with upadacitinib, UC patients being treated with ozanimod had a significantly increased risk of vascular and neuromusculoskeletal complications and a significantly reduced risk of infections and skin and subcutaneous adverse reactions (Figure 1).Figure 1.: Risk Ratio of Reported Events in Ozanimod vs Upadacitinib in Ulcerative Colitis.

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.

How this classification was reachedexpand

Full frame distilled prediction

Teacher imitation

Not calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.

metaresearch head score (Codex)0.001
metaresearch head score (Gemma)0.000
Version: codex-gemma-dda1882f352aValidation status: machine_predicted_unvalidated
Candidate categoriesnone
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Observational · Consensus signal: Observational
GenreCandidate signal: Empirical · Consensus signal: Empirical
Teacher disagreement score0.008
Threshold uncertainty score0.285

Codex and Gemma teacher scores by category

CategoryCodexGemma
Metaresearch0.0010.000
Meta-epidemiology (narrow)0.0000.000
Meta-epidemiology (broad)0.0010.000
Bibliometrics0.0000.000
Science and technology studies0.0000.001
Scholarly communication0.0000.000
Open science0.0000.000
Research integrity0.0000.000
Insufficient payload (model declined to judge)0.0000.000

Machine scores (provisional)

The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.

Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.

Opus teacher head0.022
GPT teacher head0.318
Teacher spread0.296 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it

Classification

machine, unvalidated

Machine predicted; a candidate call from one teacher head, not a consensus.

The models applied no category: nothing in the taxonomy fit this work.
Study designObservational
Domainnot available
GenreEmpirical

How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".

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Citations0
Published2023
Admission routes1
Has abstractyes

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