Adverse Events and Drug Interactions Associated with Elexacaftor/Tezacaftor/Ivacaftor Treatment: A Descriptive Study Across Australian, Canadian, and American Adverse Event Databases
Abstract
1. Introduction
2. Aim
3. Ethics Approval
4. Methods
4.1. Study Design and Data Sources
4.2. Search Strategy
4.3. Data Analysis
5. Results
6. Discussion
7. Conclusions
Supplementary Materials
Author Contributions
Funding
Data Availability Statement
Conflicts of Interest
References
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Australia | Canada | U.S. | ||||
---|---|---|---|---|---|---|
Number of adverse events reports | n = 45 | n = 80 | n = 10,503 | |||
Patient demographics | ||||||
Gender | ||||||
No. Males | 18 | (40%) | 34 | (43%) | 4029 | (38%) |
No. Females | 17 | (38%) | 41 | (51%) | 5333 | (51%) |
Unspecified | 10 | (22%) | 5 | (6%) | 1141 | (11%) |
Age | ||||||
By age 0 to 11 yrs | 7 | (16%) | 10 | (12%) | 429 | (4%) |
12 to 17 yrs | 6 | (13%) | 12 | (15%) | 944 | (9%) |
18 to 64 yrs | 19 | (42%) | 51 | (64%) | 3571 | (34%) |
65 to 85 yrs | 1 | (2%) | 1 | (1%) | 134 | (1%) |
>85 yrs | 1 | |||||
Unspecified | 12 | (27%) | 6 | (8%) | 5424 | (52%) |
Australia | Canada | U.S. | ||||
---|---|---|---|---|---|---|
Number of adverse events by SOC | n = 179 | n = 254 | n = 19,595 | |||
Blood and lymphatic system disorders | 2 | (1.1%) | - | 78 | (0.4%) | |
Cardiac disorders | 2 | (1.1%) | 1 | (0.4%) | 109 | (0.6%) |
Congenital, familial, and genetic disorders | - | 2 | (0.8%) | 222 | (1.1%) | |
Ear and labyrinth disorders | 1 | (0.6%) | - | 89 | (0.5%) | |
Endocrine disorders | - | - | 27 | (0.1%) | ||
Eye disorders | 2 | (1.1%) | - | 349 | (1.8%) | |
Gastrointestinal disorders | 24 | (13.4%) | 25 | (9.8%) | 2011 | (10.3%) |
General disorders and administration site conditions | 16 | (8.9%) | 19 | (7.5%) | 1922 | (9.8%) |
Hepatobiliary disorders | 3 | (1.7%) | 7 | (2.8%) | 403 | (2.1%) |
Immune system disorders | - | 2 | (0.8%) | 149 | (0.8%) | |
Infections and infestations | 10 | (5.6%) | 18 | (7.1%) | 2242 | (11.4%) |
Injury, poisoning, and procedural complications | 5 | (2.8%) | 11 | (4.3%) | 910 | (4.6%) |
Investigations | 20 | (11.2%) | 45 | (17.7%) | 1803 | (9.2%) |
Metabolism and nutrition disorders | 8 | (4.5%) | 5 | (2.0%) | 463 | (2.4%) |
Musculoskeletal and connective tissue disorders | 4 | (2.2%) | 9 | (3.5%) | 466 | (2.4%) |
Neoplasms benign, malignant, and unspecified | 1 | (0.6%) | - | 86 | (0.4%) | |
Nervous system disorders | 9 | (5.0%) | 12 | (4.7%) | 1511 | (7.7%) |
Pregnancy, puerperium, and perinatal conditions | 3 | (1.7%) | 6 | (2.4%) | 176 | (0.9%) |
Product issues | - | - | 32 | (0.2%) | ||
Psychiatric disorders | 28 | (15.6%) | 39 | (15.3%) | 1451 | (7.4%) |
Renal and urinary disorders | 2 | (1.1%) | 3 | (1.2%) | 211 | (1.1%) |
Reproductive system and breast disorders | - | 1 | (0.4%) | 198 | (1.0%) | |
Respiratory, thoracic, and mediastinal disorders | 14 | (7.8%) | 7 | (2.8%) | 1955 | (10 |
Skin and subcutaneous tissue disorders | 17 | (9.5%) | 30 | (11.8%) | 1251 | (6.4%) |
Social circumstances | 1 | (0.6%) | - | 79 | (0.4%) | |
Surgical and medical procedures | 5 | (2.8%) | 11 | (4.3%) | 1286 | (6.6%) |
Vascular disorders | 2 | (1.1%) | 1 | (0.4%) | 116 | (0.6%) |
No. of Reports | Unknown Dose * | Dose Reduced/Switched *** | Standard Dose ** | Dose Reduced/Switched *** |
---|---|---|---|---|
Anxiety (n = 188) | 128 (68%) | 30 (16%) | 60 (32%) | 23 (12%) |
Depression (n = 136) | 83 (61%) | 17 (13%) | 53 (39%) | 15 (11%) |
Anxiety and depression (n = 105) | 57 (54%) | 10 (10%) | 48 (46%) | 23 (22%) |
Drug—CYP 3A 4/5 Inhibitor | Inhibitor Strength Level * | No. of Reports | Drug—CYP 3A 4/5 Inducer | Inducer Strength Level * | No. of Reports | Drug- Substrates CYP 2C9 | No. of Reports |
---|---|---|---|---|---|---|---|
Atomoxetine | Weak | 6 | Carbamazepine | Strong | 2 | Amitriptyline | 38 |
Ciprofloxacin | Moderate | 183 | Prednisolone/Prednisone | Weak | 241 | Celecoxib | 24 |
Clarithromycin | Strong | 37 | Rifabutin | Weak | 1 | Diclofenac | 17 |
Erythromycin | Moderate | 17 | Rifampin | Strong | 7 | Doxepin | 2 |
Fluconazole | Moderate | 41 | Fluoxetine | 86 | |||
Itraconazole | Strong | 19 | Glipizide | 4 | |||
Ketoconazole | Strong | 4 | Ibuprofen | 144 | |||
Posaconazole | Strong | 24 | Irbesartan | 5 | |||
Voriconazole | Strong | 17 | Losartan | 12 | |||
Naproxen | 29 | ||||||
Rosuvastatin | 15 | ||||||
Torsemide | 8 | ||||||
Venlafaxine | 31 | ||||||
Warfarin | 12 |
CYP 3A4/5 Inhibitor | No. of Reports Dose Modified | No. of Reports Dose not Changed | No. of Reports Dose Unknown | |||
---|---|---|---|---|---|---|
Itraconazole (n = 16) | 10 | (63%) | 1 | (6%) | 5 | (31%) |
Fluconazole (n = 14) | 7 | (50%) | 1 | (7%) | 6 | (43%) |
Posaconazole (n = 16) | 11 | (69%) | 3 | (19%) | 2 | (12%) |
Voriconazole (n = 11) | 6 | (55%) | 1 | (9%) | 4 | (36%) |
Erythromycin (n = 4) | 1 | (25%) | 1 | (25%) | 2 | (50%) |
Clarithromycin (n = 7) | 1 | (14%) | 3 | (43%) | 3 | (43%) |
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Thiruchelvam, T.; Lim, C.X.; Munro, C.; Chan, V.; Jayasuria, G.; Coulthard, K.P.; Wark, P.A.B.; Suppiah, V. Adverse Events and Drug Interactions Associated with Elexacaftor/Tezacaftor/Ivacaftor Treatment: A Descriptive Study Across Australian, Canadian, and American Adverse Event Databases. Life 2025, 15, 1256. https://doi.org/10.3390/life15081256
Thiruchelvam T, Lim CX, Munro C, Chan V, Jayasuria G, Coulthard KP, Wark PAB, Suppiah V. Adverse Events and Drug Interactions Associated with Elexacaftor/Tezacaftor/Ivacaftor Treatment: A Descriptive Study Across Australian, Canadian, and American Adverse Event Databases. Life. 2025; 15(8):1256. https://doi.org/10.3390/life15081256
Chicago/Turabian StyleThiruchelvam, Theeba, Chiao Xin Lim, Courtney Munro, Vincent Chan, Geshani Jayasuria, Kingsley P. Coulthard, Peter A. B. Wark, and Vijayaprakash Suppiah. 2025. "Adverse Events and Drug Interactions Associated with Elexacaftor/Tezacaftor/Ivacaftor Treatment: A Descriptive Study Across Australian, Canadian, and American Adverse Event Databases" Life 15, no. 8: 1256. https://doi.org/10.3390/life15081256
APA StyleThiruchelvam, T., Lim, C. X., Munro, C., Chan, V., Jayasuria, G., Coulthard, K. P., Wark, P. A. B., & Suppiah, V. (2025). Adverse Events and Drug Interactions Associated with Elexacaftor/Tezacaftor/Ivacaftor Treatment: A Descriptive Study Across Australian, Canadian, and American Adverse Event Databases. Life, 15(8), 1256. https://doi.org/10.3390/life15081256