A Comparison of Active Pharmacovigilance Strategies Used to Monitor Adverse Events to Antiviral Agents: A Systematic Review

Renato Ferreira-da-Silva (), Joana Reis-Pardal, Manuela Pinto, Matilde Monteiro-Soares, Bernardo Sousa-Pinto, Manuela Morato, Jorge Junqueira Polónia and Inês Ribeiro-Vaz
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Renato Ferreira-da-Silva: Faculty of Medicine of the University of Porto
Joana Reis-Pardal: Associate Laboratory RISE—Health Research Network (CINTESIS@RISE)
Manuela Pinto: São João University Hospital Centre
Matilde Monteiro-Soares: Associate Laboratory RISE—Health Research Network (CINTESIS@RISE)
Bernardo Sousa-Pinto: Associate Laboratory RISE—Health Research Network (CINTESIS@RISE)
Manuela Morato: Faculty of Pharmacy of the University of Porto
Jorge Junqueira Polónia: Faculty of Medicine of the University of Porto
Inês Ribeiro-Vaz: Faculty of Medicine of the University of Porto

Drug Safety, 2024, vol. 47, issue 12, No 3, 1203-1224

Abstract: Abstract Introduction The safety of antiviral agents in real-world clinical settings is crucial, as pre-marketing studies often do not capture all adverse events (AE). Active pharmacovigilance strategies are essential for detecting and characterising these AE comprehensively. Objective The aim of this study was to identify and characterise active pharmacovigilance strategies used in real-world clinical settings for patients under systemic antiviral agents, focusing on the frequency of AE and the clinical data sources used. Methods We conducted a systematic review by searching three electronic bibliographic databases targeting observational prospective active pharmacovigilance studies, phase IV clinical trials for post-marketing safety surveillance, and interventional studies assessing active pharmacovigilance strategies, focusing on individuals exposed to systemic antiviral agents. Results We included 36 primary studies, predominantly using Drug Event Monitoring (DEM), with a minority employing sentinel sites and registries. Human immunodeficiency virus (HIV) was the most common condition, with the majority using DEM. Within the DEM, there was a wide range of incidences of patients experiencing at least one AE, and most of these studies used one or two data sources. Sentinel site studies were less common, with two on hepatitis C virus (HCV) and one on HIV, each relying on one or two data sources. The single study using a registry focusing on HIV therapy reported using just one data source. Patient interviews were the most common data source, followed by medical records and laboratory tests. The quality of the studies was considered ‘good’ in 18/36, ‘fair’ in 1/36, and ‘poor’ in 17/36 studies. Conclusion DEM was the predominant pharmacovigilance strategy, employing multiple data sources, and appears to increase the likelihood of detecting higher AE incidence. Establishing such a framework would facilitate a more detailed and consistent approach across different studies and settings.

Date: 2024
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DOI: 10.1007/s40264-024-01470-0

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