Comparison of signal detection of tumour necrosis factor-α inhibitors using the Korea Adverse Events Reporting System Database, 2005–2016

  • Dongmun Ha
  • Seung Eun Lee
  • Inmyung Song
  • Sung Jun Lim
  • Ju-Young ShinEmail author
Original Article



There are no pharmacovigilance studies on adverse event (AE) data for tumour necrosis factor alpha (TNFα) inhibitors in South Korea. We analysed AEs induced by adalimumab, infliximab, and etanercept


We used data from the Korea Institute of Drug Safety and Risk Management–Korea Adverse Events Reporting System Database (KIDS-KD) collected between 2005 and 2016. We used three different signal detection methods: proportional reporting ratio (PRR), reporting odds ratio (ROR), and information component (IC). The drug was compared with drug labels in the USA and Korea. Logistic regression analysis identified AEs that are more likely to occur with drug use.


Of the 5594 AEs identified, 350, 452, and 71 were related to adalimumab, infliximab, and etanercept, respectively. We identified seven new signals, which were not listed on drug labels in either Korea or the USA, for AEs associated with the study drugs: two for adalimumab (medication error and drug failure), two for infliximab (palpitation and temperature sensation change), and three for etanercept (hyperkeratosis, acne, and thyroid neoplasm malignant). Injection site pain (OR 6.14, 95% CI 1.15–32.74) and alopecia (OR 4.54, 95% CI 1.16–17.77) for adalimumab, chest pain (OR 6.01, 95% CI 1.35–26.77) for infliximab, and uveitis (OR 10.11, 95% CI 1.13–90.77) for etanercept were more likely to be reported in patients with each TNFα inhibitor than in those without, respectively.


Seven new signals that were not included in the current label were identified for TNFα inhibitors and should be updated and monitored.

Key Points

Large-scale spontaneous AE reporting data and data mining techniques are useful for detecting signals of rare AEs as well as common AEs induced by drugs.

Drug labels should be updated to reflect signals that are newly discovered by continuous monitoring.


Data mining Drug-AE Drug label KIDS-KD Signal detection Tumour necrosis factor-α inhibitors 


Compliance with ethical standards

Ethical approval

This study was approved by the Institutional Review Board of Sungkyunkwan University in Korea (SKKU-IRB-2018-02-005).

Informed consent

Informed consent was waived by the Institutional Review Board for this study because all personal information on patients was anonymous.




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Copyright information

© International League of Associations for Rheumatology (ILAR) 2019

Authors and Affiliations

  1. 1.School of PharmacySungkyunkwan UniversitySuwon-siSouth Korea
  2. 2.College of Nursing and HealthKongju National UniversityChungnamSouth Korea

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