Evidence map›Paper›PMID 41678139›Full record

ArticleAdvances in therapy2026

A Comprehensive Approach to Selection of Adverse Drug Reactions for a Drug with Conditional Marketing Authorisation in the European Union.

Norbert Hittel, Natasa Lazarevic, Alexandra Martin, Britta Schorn, Axel Leporowski, Vivian Zhang, Vinu George, Emiel van Heumen

Abstract read
In one paragraph

Article in Advances in therapy, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

8 authors.

Norbert HittelOtsuka Novel Products GmbH, Munich, Germany. nhittel@otsuka-onpg.com.
Natasa LazarevicOtsuka Novel Products GmbH, Munich, Germany.
Alexandra MartinOtsuka Novel Products GmbH, Munich, Germany.
Britta SchornOtsuka Pharma GmbH, Frankfurt, Germany.
Axel LeporowskiOtsuka Pharma GmbH, Frankfurt, Germany.
Vivian ZhangOtsuka Pharmaceutical Development and Commercialization, Princeton, NJ, USA.
Vinu GeorgeOtsuka Pharmaceutical Development and Commercialization, Princeton, NJ, USA.
Emiel van HeumenOtsuka Pharma GmbH, Frankfurt, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionDelamanid (Deltyba®), a medicinal product with an orphan designation for the treatment of tuberculosis, received a conditional marketing authorisation in the European Union (EU) based on phase 2 data, while phase 3 trial was ongoing. The list of adverse drug reactions (ADRs) in the original Summary of Product Characteristics (SmPC) contained all adverse events (AEs) considered related by the investigator that were reported in at least one of the 321 patients receiving delamanid. The safety profile observed after completion of the phase 3 clinical trial, post-marketing studies and spontaneous reports from post-marketing appeared different from what the initial SmPC was indicating. A comprehensive analysis was undertaken aiming to provide evidence for identification of a well-substantiated and clinically useful delamanid safety profile.

methodsIn support of the process of ADR identification, a statistical methodology of data from controlled clinical trials was introduced based on the estimation of risk difference and risk ratio for identification of a potential risk from delamanid in high and low incidence situations. Final medical assessment was supported by this statistical analysis of data from controlled clinical trials, any signal from all other Otsuka-sponsored clinical trials, along with data from post-marketing solicited and unsolicited sources.

resultsADRs were either retained, added to or removed from the ADR list with the same or modified frequency. Thus, the total number of ADRs listed in the original SmPC was significantly reduced.

conclusionA combination of statistical parameters and medical judgement should be considered for the selection of undesirable effects for the product label and for the safety risk classification.

Indexed as

Antitubercular AgentsDrug ApprovalDrug-Related Side Effects and Adverse ReactionsNitroimidazolesOxazolesAdverse Drug Reaction Reporting SystemsClinical Trials, Phase III as TopicEuropean UnionHumansProduct Surveillance, PostmarketingTuberculosisAntitubercular AgentsNitroimidazolesOPC-67683OxazolesAdverse drug reactionAdverse eventDelamanidLabelSmPCStatistical methodologySummary of Product CharacteristicsTuberculosis

Identifiers

PMID41678139
PMCPMC13065594

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Registered trials

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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 OpenQuestion graph.