Adverse events of pegvaliase in the treatment of phenylketonuria: A pharmacovigilance study based on the FAERS database

Pegvaliase was approved by the FDA in 2018 for the treatment of phenylketonuria(PKU).However, the long-term safety of pegvaliase in a large sample population is unclear. The purpose of this study was to investigate the adverse events associated with pegvaliase in the real world by mining data from the FAERS database. We extract adverse event data on pegvaliase from the FAERS database and perform a disproportionality analysis utilizing ROR，PRR，BCPNN and MGPS. A total of 82 preferred terms (PTs) simultaneously met the criteria of all four algorithms. Common PTs include reactions at the injection site，joint pain, sensitivity reactions, headaches, skin reactions, injection site pruritus, and rash pruritic, corresponding to adverse events reported in clinical trials. Unexpected significant adverse events were identified, such as amino acid level decreased or increased, panic attacks, self-injurious ideation, disturbances in attention, tunnel vision, and so on. The median onset time for adverse events to pegvaliase is 15 days(IQR = 9-42 days), with the majority occurring within 30 days (n=509, 67.78%). The top three drugs most commonly prescribed in conjunction with pegvaliase are famotidine, cetirizine, and sapropterin. When pegvaliase is used in combination with these drugs, it is associated with an increase or decrease in the risk of certain adverse events. Our study provides crucial insights for the safer and more effective use of pegvaliase.