Aneurysm and Artery Dissection Following the use of Vascular Endothelial Growth Factor Inhibitor: A Real-World Analysis Using a Spontaneous Reporting System

Background: There are few real-world studies comparing the incidence, clinical features, and prognosis of aneurysm and artery dissection related to various vascular endothelial growth factor inhibitor (VPI) regimens. This study evaluated the recent evidence of aneurysm and artery dissection after VPI therapy. The purpose was to evaluate and compare the links between different VPIs and aneurysm and artery dissection by investigating the Food and Drug Administration Adverse Event Reporting System (FAERS). Methods: Using FAERS data from January 2004 to March 2020, disproportionality analysis was used for data mining to screen suspected aneurysm and artery dissection cases after different VPI treatments. The times to onset and fatality rates of suspected drugs were also investigated to assess prognoses. Results: In total, there were 634 reports of aneurysm and artery dissection events after VPI. Ramucirumab appeared to have a stronger association than other VPIs, based on the reporting odds ratio (ROR = 3.68, 95% [2.18, 6.23]). The results showed a significant difference in onset time (P < 0.001), and a quick onset occurred in 60.13% of cases. The median time to aneurysm and artery dissection was 79.5 (IQR: 19–273.5) days after VPI administration. The results also showed that men were more affected than women (59.68% vs. 40.32%), and patients older than 45 years were more affected than younger patients (68.12% vs. 3.93%). Finally, the suspected drugs generally led to a 19.98% fatality rate and a 29.81% hospitalization rate. The highest death rate was associated with Aflibercept (25.49%). Conclusions: We identified signals for aneurysm and artery dissection following various VPIs in real-world practice using the FAERS, which represents the first step for continued pharmacovigilance investigation.