Evidence mapPaperPMID 41240270Full record

ArticleInternational journal of clinical pharmacy2026

Post-marketing safety profile of cladribine in multiple sclerosis: a disproportionality analysis based on the FDA adverse event reporting system.

Yuwen Hu, Jianghai He, Zheng Tu, Hongyu Ye, Caixiang Zhuang, Ziyang Jin, Haoxiang Hu, Yunhan Zhao, Yanyan Zheng, Qiong Yao

Abstract read
In one paragraph

Article in International journal of clinical pharmacy, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Yuwen Hu *Department of Neurology, Postgraduate Training Base Alliance of Wenzhou Medical University, Wenzhou People's Hospital, Wenzhou, 325000, Zhejiang, China.
Jianghai He *Department of Neurology, Postgraduate Training Base Alliance of Wenzhou Medical University, Wenzhou People's Hospital, Wenzhou, 325000, Zhejiang, China.
Zheng TuDepartment of Neurology, Postgraduate Training Base Alliance of Wenzhou Medical University, Wenzhou People's Hospital, Wenzhou, 325000, Zhejiang, China.
Hongyu YeDepartment of Neurology, Postgraduate Training Base Alliance of Wenzhou Medical University, Wenzhou People's Hospital, Wenzhou, 325000, Zhejiang, China.
Caixiang ZhuangDepartment of Neurology, Postgraduate Training Base Alliance of Wenzhou Medical University, Wenzhou People's Hospital, Wenzhou, 325000, Zhejiang, China.
Ziyang JinDepartment of Neurology, Postgraduate Training Base Alliance of Wenzhou Medical University, Wenzhou People's Hospital, Wenzhou, 325000, Zhejiang, China.
Haoxiang HuDepartment of Neurology, Postgraduate Training Base Alliance of Wenzhou Medical University, Wenzhou People's Hospital, Wenzhou, 325000, Zhejiang, China.
Yunhan ZhaoDepartment of Neurology, Postgraduate Training Base Alliance of Wenzhou Medical University, Wenzhou People's Hospital, Wenzhou, 325000, Zhejiang, China.
Yanyan ZhengWenzhou Third Clinical Institute Affiliated to Wenzhou Medical University, Wenzhou People's Hospital, Wenzhou, 325000, Zhejiang, China. yying33171@163.com.
Qiong YaoWenzhou Third Clinical Institute Affiliated to Wenzhou Medical University, Wenzhou People's Hospital, Wenzhou, 325000, Zhejiang, China. 13736744198@163.com.

Funding

Natural Science Foundation of Zhejiang Province LTGY23H090014
6 · The paper itself

Abstract

introductionCladribine has been widely recognized as a therapeutic option for relapsing-remitting multiple sclerosis (MS), but there is still a dearth of real-world data regarding its safety profile.

aimThis study aimed to assess adverse events (AEs) linked to cladribine in MS patients, utilizing data from the U.S. Food and Drug Administration Adverse Event Reporting System (FAERS).

methodAE reports identifying cladribine as the primary suspect drug were extracted from the U.S. FAERS, covering the period from the first quarter of 2019 to the third quarter of 2024. Four disproportionality methods-reporting odds ratio (ROR), proportional reporting ratio, Bayesian confidence propagation neural network, and empirical Bayes geometric mean-were employed to evaluate the association between cladribine and AEs. Furthermore, the Weibull distribution model was applied to analyze time-to-onset patterns, and subgroup analyses were conducted based on sex and age.

resultsAfter screening 4,833 cladribine-related reports, 113 preferred terms (PTs) were identified as positive across all four disproportionality methods. Known AEs such as pneumonia (n = 190, ROR 2.85), lymphopenia (n = 111, ROR 4.19), and drug-induced liver injury (n = 22, ROR 5.94). Unexpected events, including rheumatoid arthritis (ROR 5.64), hypothyroidism (ROR 5.04), eye hemorrhage (ROR 6.88), uveitis (ROR 4.86), retinal detachmen (ROR 4.37), brain edema (ROR 6.12), acute myocardial infarction (ROR 3.70), and completed suicide (ROR 7.46), were also reported. Stratified analysis revealed that females were at a higher risk of nausea, alopecia, and migraine, while males were more susceptible to gait disturbance and sepsis. Older adults (≥ 65 years) faced increased risks of leukopenia and urinary tract infections (UTIs). The median onset of AEs was 152 days, with the highest proportion (28.18%) reported in the first month. Weibull analysis indicated an early peak (shape parameter 0.72).

conclusionThis study not only corroborates previously established risks associated with cladribine but also uncovers new potential safety signals, highlighting the importance of vigilance for early acute toxicity.

Indexed as

Adverse Drug Reaction Reporting SystemsCladribineImmunosuppressive AgentsMultiple SclerosisMultiple Sclerosis, Relapsing-RemittingProduct Surveillance, PostmarketingAdolescentAdultAgedDrug-Related Side Effects and Adverse ReactionsFemaleHumansMaleMiddle AgedPharmacovigilanceUnited StatesCladribineImmunosuppressive AgentsAdverse eventsCladribineDisproportionality analysisFAERS databasePharmacovigilance

Identifiers

PMID41240270
PMCPMC12992368

What Socratic holds

Textmetadata
LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.