Drug-induced immune-mediated uveitis: a real-world pharmacovigilance analysis using FAERS and JADER databases

To analyse drug-associated immune-mediated uveitis (IMU) risk using large-scale pharmacovigilance data.

We conducted a retrospective pharmacovigilance study using data from the FDA Adverse Event Reporting System (FAERS) and the Japanese Adverse Drug Event Report (JADER) databases, encompassing reports from Q1 2004 to Q4 2024. Disproportionality analysis identified drug-IMU associations using reporting odds ratios (ROR) and information component (IC). Time-to-onset (TTO) was also assessed.

Disproportionality analysis identified 17 176 IMU cases in FAERS and 2580 in JADER. IMU prevalence was higher in females, with the 30-80 age group most affected. Antineoplastic and immunomodulating agents, sensory organ drugs and anti-infectives were the most frequently associated drug classes with IMU. Among 117 drugs with positive signals for IMU in FAERS, brolucizumab (ROR₀₂₅=145.89, IC₀₂₅=7.08), faricimab (ROR₀₂₅=134.06, IC₀₂₅=6.97) and rifabutin (ROR₀₂₅=82.23, IC₀₂₅=6.32) exhibited the strongest associations. The three drugs also ranked as the top three drugs with the strongest association with IMU in JADER. The study also highlights significant differences in TTO among various drug classes, with musculoskeletal and sensory organ drugs showing longer TTO compared with other categories.

Our study highlights the diverse range of drugs implicated in the occurrence or progression of IMU. These findings emphasise the need for early risk assessment, careful monitoring and positive intervention in managing treatments involving high-risk drugs. Future research should focus on elucidating underlying mechanisms and risk factors to develop safer therapeutic strategies.