Objectives: This pharmacovigilance analysis was conducted to assess the safety signals of FMS-related tyrosine kinase 3 (FLT3) inhibitors in a real-world setting using the United States Food and Drug Administration Adverse Event Reporting System (FAERS). Design: We analyzed adverse event (AE) reports related to FLT3 inhibitors submitted to the FAERS database from the first quarter of 2015 to the fourth quarter of 2022. Disproportionality analysis was used to identify AEs of FLT3 inhibitors in the FAERS database. Results: A total of 55,393 AE reports were identified, of which 5938, 44,013, and 5442 were attributed to midostaurin, sorafenib, and gilteritinib, respectively, as primary suspects. Compared to the full database, significant safety signals at the system organ class level were observed for midostaurin (blood and lymphatic system disorders and hepatobiliary disorders), sorafenib (skin and subcutaneous tissue disorders and hepatobiliary disorders), and gilteritinib (investigations, blood and lymphatic system disorders, infections and infestations, and hepatobiliary disorders). All the drugs studied were associated with hepatobiliary disorders. The most prominent AEs associated with midostaurin, sorafenib, and gilteritinib were cytopenia, palmar-plantar erythrodysesthesia syndrome, and increased blast cell count, respectively. Compared with chemotherapy, midostaurin and gilteritinib showed a higher risk of electrocardiogram QT prolongation, gastrointestinal hemorrhage, cerebral hemorrhage, and increased white blood cell count. Gilteritinib had the highest overall death percentage (30.28%), whereas sorafenib had the lowest (23.06%). Conclusion: Mining AE signals using the FAERS database provides a method for analyzing the safety of FLT3 inhibitors in post-marketing. We found several significant AE signals that corresponded to previous studies; however, some AE signals were not mentioned in the drug instructions. Our study could provide a direction for follow-up real-world studies to verify the results further.

Background: The combination of polatuzumab, bendamustine and rituximab (pola+BR) was authorized for the treatment of relapsed or refractory Diffuse large B cell lymphoma (DLBCL). This study used the FDA database to identify safety signals related to the treatment protocol.Methods: The adverse events (AEs) from 2019Q1 to 2023Q3 were analyzed by calculating the reporting odds ratio. Severe and non-severe cases were compared using either an independent samples t-test or chi-squared (χ²) test. Additionally, a score sheet was employed to prioritize the signals.Results: In all database, 58 significant signals were detected within 1,597 patients accepting the treatment protocol. Common AEs like neutropenia, thrombocytopenia, and peripheral neuropathy, as well as other AEs like anaemia, sepsis, cytokine release syndrome and immune effector cell-associated neurotoxicity syndrome (ICANS) were a major focus. In addtion, 51.7%, 45.6% and 1.7% were sorted into low, moderate and high priority in term of clinical importance, respectively. Unexpected significant signals included intestinal obstruction, epilepsy, deep vein thrombosis, haemorrhage, increased blood lactate dehydrogenase and hypercalcemia.Conclusion: Our study identified significant AE signals for pola+BR through realworld disproportionality analysis data and analyzed the severity and clinical priority of these signals, which can assist clinicians in managing related AEs.