Thromboembolic events with the use of immune checkpoint inhibitors (ICIs) in patients with cancer have been reported in few studies. However, the detailed profile of these cases remains mostly uncertain. A descriptive analysis of Thromboembolic events associated with ICIs retrieved from the VigiBase, between 1967 to November 2020. We extracted the data using the terms of ‘pulmonary embolism’ OR ‘deep vein thrombosis’ OR ‘acute coronary syndrome’ OR ‘myocardial infarction’ OR ‘ischemic stroke’ (preferred term (PT) (MedDRA). We included 161 cases from 26 countries in our descriptive analysis. Patients’ ages were reported in 141 (87.6%) cases, with a median of 68 years (interquartile range 61–74), and 63.4% of the patients were male. Indications for ICIs were reported in 151 (93.8%) cases, as follows: lung cancer (n = 85, 52.8%), renal cell carcinoma (n = 24, 14.9%), melanoma (n = 20, 12.4%), urethral carcinoma (n = 12, 7.45%), breast cancer (n = 4, 2.48%), adenocarcinoma of the gastroesophageal junction (n = 3, 1.9%), gastric cancer (n = 2, 1.24%), and skin cancer (n = 1, 0.62%). Nivolumab was reported as a suspected drug in 76 cases (47%), pembrolizumab in 46 cases (28.5%), atezolizumab in 21 cases (13%), durvalumab in 14 cases (8.6%), and avelumab in four cases (2.4%). The time to onset of thromboembolic events was reported in 127 (78.8%) cases. Most of these patients (n = 109, 85.8%) reported thromboembolic events within the first six months. The causality assessment of included cases showed that 50.3% of reported thromboembolic events were possibly related to the suspected reported medication, 13.7% were probably related, 13% were unlikely to be related, and 23% were not assessable due to insufficient information. This study demonstrates a possible association between the use of ICIs and thromboembolic events. Further epidemiological studies are needed to assess this association and to elucidate the underlying mechanism.

Health outcomes and policies is a growing areas that is needed in the healthcare culture. This study aimed to examine the availability, extent and type of teaching curricula (pharmacoeconomics, pharmacoepidemiology, pharmacovigilance, patient safety) in Arab countries. A retrospective observational study was conducted during the period of November 2019 to January 2020. The collection strategy was performed by listing of pharmacy colleges in each country and then reviewing the institutions’ websites that met the inclusion criteria. Five criteria were utilized to assess the availability of these courses: full-time mandatory, full-time elective, partial mandatory, partial elective, and not offered. One hundred ninety-one academic institutions were screened during the study period. Of those, 151 (79.1%) institutions were included in the study and their curricular descriptions were retrieved from their electronic websites. Pharmacoeconomics was the most taught subject among the four subjects. It was offered in 89/151 of the colleges among Arab countries. Among these 89 colleges that offered pharmacoeconomics, 74/89 offered it as a mandatory. While, Pharmacoepidemiology was offered in 51 colleges, with 44/51 offering the subject as a mandatory, and 6 out of those 44 list it as a full-time mandatory, while 38 out of those 44 offer it as a partially mandatory. Only 22 of the colleges offered pharmacovigilance, with 14/22 offering the subject as a mandatory. Finally, there was only one institution that offers the subject of patient safety. Moreover, most of the four courses investigated are only taught in the final two years of study. The study found a clear shortcoming in the teaching pharmaceutical outcomes. More efforts are needed by academic institutions to adopt and teach these subjects to ensure they meet the work needs and advanced pharmacy practice transformation.