{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T05:19:29Z","timestamp":1788326369289,"version":"build-2803163510"},"reference-count":45,"publisher":"MDPI AG","issue":"17","license":[{"start":{"date-parts":[[2026,8,30]],"date-time":"2026-08-30T00:00:00Z","timestamp":1788048000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100015999","name":"\u201cLucian Blaga\u201d University of Sibiu","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100015999","id-type":"DOI","asserted-by":"crossref"}]},{"id":[{"id":"https:\/\/ror.org\/026gdz537","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. Clin. Med.","JCM"],"abstract":"<jats:p>Background\/Objectives: Anthracycline-induced cardiotoxicity may compromise cancer treatment and long-term outcomes. Although differences in the cardiotoxicity profile of epirubicin and doxorubicin have been reported, direct comparative pharmacovigilance evidence remains limited. This study compared their cardiovascular adverse reaction reporting profiles using EudraVigilance (EV) data. Methods: Aggregated Individual Case Safety Reports submitted up to 12 July 2026 on the European portal were analyzed. Descriptive analyses assessed demographic characteristics, report origin, reporter type, System Organ Class distribution, seriousness, and clinical outcomes. Cardiotoxicity-related preferred terms (PTs) were identified using the Standardized MedDRA Queries \u201cCardiac failure\u201d, \u201cCardiomyopathy\u201d, and \u201cMyocardial infarction\u201d. Comparative disproportionality analysis was restricted to reports submitted by healthcare professionals. Reporting odds ratios and 95% confidence intervals were calculated for PTs with at least five reports for each drug. Results: Overall, 52,257 reports for doxorubicin and 31,049 for epirubicin were identified. Cardiac disorders were reported in 4459 doxorubicin cases and 1406 epirubicin cases, with over 97% classified as serious. Among 51 cardiotoxicity-related PTs, doxorubicin showed significantly higher reporting odds for cardiogenic shock, congestive, chronic, acute, and left ventricular cardiac failure, decreased ejection fraction, cardiomyopathy, cardiotoxicity, toxic cardiomyopathy, acute myocardial infarction, myocardial infarction, and increased troponin. The strongest disproportionality signals were observed for cardiogenic shock, toxic cardiomyopathy, cardiomyopathy, and cardiotoxicity. Conclusions: Doxorubicin was associated with a more pronounced pattern of cardiotoxicity-related reporting and disproportionality signals than epirubicin in the EV database. These findings highlight potential differences in the cardiovascular safety profiles of the two anthracyclines and provide signals that warrant further investigation, while underscoring the importance of cardiovascular risk assessment and monitoring in patients receiving anthracycline therapy. However, disproportionality signals do not establish incidence, absolute risk, or causality and require confirmation in prospective comparative studies.<\/jats:p>","DOI":"10.3390\/jcm15176734","type":"journal-article","created":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T05:45:13Z","timestamp":1788241513000},"page":"6734","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Comparative Pharmacovigilance Analysis of Selected Cardiotoxicity Signals Associated with Doxorubicin and Epirubicin Based on EudraVigilance Data"],"prefix":"10.3390","volume":"15","author":[{"given":"Emilia Sorina","family":"Fiat","sequence":"first","affiliation":[{"name":"Faculty of Medicine, \u201cLucian Blaga\u201d University of Sibiu, 550169 Sibiu, Romania"},{"name":"Department of Cardiology, County Clinical Emergency Hospital, 550245 Sibiu, 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Heart J."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"655","DOI":"10.1016\/j.jaccao.2024.07.016","article-title":"Anthracycline Cardiotoxicity in Adult Cancer Patients: JACC: CardioOncology State-of-the-Art Review","volume":"6","author":"Camilli","year":"2024","journal-title":"JACC. CardioOncol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1981","DOI":"10.1161\/CIRCULATIONAHA.114.013777","article-title":"Early Detection of Anthracycline Cardiotoxicity and Improvement with Heart Failure Therapy","volume":"131","author":"Cardinale","year":"2015","journal-title":"Circulation"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"e35770","DOI":"10.1097\/MD.0000000000035770","article-title":"Anthracyclines and the Risk of Arrhythmias: A Systematic Review and Meta-Analysis","volume":"102","author":"Dean","year":"2023","journal-title":"Medicine"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"3105","DOI":"10.1007\/s00018-020-03729-y","article-title":"Molecular Mechanisms of Doxorubicin-Induced Cardiotoxicity: Novel Roles of Sirtuin 1-Mediated Signaling Pathways","volume":"78","author":"Wang","year":"2021","journal-title":"Cell. Mol. Life Sci."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1038\/s41514-024-00135-7","article-title":"A Review of the Pathophysiological Mechanisms of Doxorubicin-Induced Cardiotoxicity and Aging","volume":"10","author":"Linders","year":"2024","journal-title":"npj Aging"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"143","DOI":"10.1007\/978-1-0716-0759-6_10","article-title":"Extracellular Vesicles and Their Roles in Cancer Progression","volume":"2174","author":"Chang","year":"2021","journal-title":"Methods Mol. Biol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"3457","DOI":"10.1200\/JCO.2011.34.7625","article-title":"Predicting Chemotherapy Toxicity in Older Adults with Cancer: A Prospective Multicenter Study","volume":"29","author":"Hurria","year":"2011","journal-title":"J. Clin. Oncol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"864","DOI":"10.1001\/jamaoncol.2018.6634","article-title":"Derivation of Anthracycline and Anthraquinone Equivalence Ratios to Doxorubicin for Late-Onset Cardiotoxicity","volume":"5","author":"Feijen","year":"2019","journal-title":"JAMA Oncol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"932","DOI":"10.1016\/j.biochi.2011.02.015","article-title":"General Oxidative Stress during Doxorubicin-Induced Cardiotoxicity in Rats: Absence of Cardioprotection and Low Antioxidant Efficiency of Alpha-Lipoic Acid","volume":"94","author":"Ghibu","year":"2012","journal-title":"Biochimie"},{"key":"ref_11","first-page":"CD005006","article-title":"Different Anthracycline Derivates for Reducing Cardiotoxicity in Cancer Patients","volume":"2010","author":"Michiels","year":"2010","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"585","DOI":"10.1007\/s40264-024-01423-7","article-title":"The REporting of A Disproportionality Analysis for DrUg Safety Signal Detection Using Individual Case Safety Reports in PharmacoVigilance (READUS-PV): Explanation and Elaboration","volume":"47","author":"Fusaroli","year":"2024","journal-title":"Drug Saf."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"e46929","DOI":"10.1097\/MD.0000000000046929","article-title":"Comparative Analysis of Adverse Events Associated with Epirubicin and Doxorubicin: An Observational Study Based on FDA Adverse Event Reporting System (FAERS) Following STROBE Guidelines","volume":"105","author":"Yang","year":"2026","journal-title":"Medicine"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"6557","DOI":"10.1038\/onc.2010.379","article-title":"Exogenous Cell-Permeable C6 Ceramide Sensitizes Multiple Cancer Cell Lines to Doxorubicin-Induced Apoptosis by Promoting AMPK Activation and MTORC1 Inhibition","volume":"29","author":"Ji","year":"2010","journal-title":"Oncogene"},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Vonica, R.C., Butuca, A., Vonica-Tincu, A.L., Morgovan, C., Pumnea, M., Cipaian, R.C., Curca, R.O., Batar, F., Vornicu, V., and Solomon, A. (2024). The Descriptive and Disproportionality Assessment of EudraVigilance Database Reports on Capecitabine Induced Cardiotoxicity. Cancers, 16.","DOI":"10.3390\/cancers16223847"},{"key":"ref_16","unstructured":"European Medicines Agency (2026, July 16). Guidelines on Good Pharmacovigilance Practices (GVP). Available online: www.ema.europa.eu."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"21709","DOI":"10.1002\/cam4.6730","article-title":"Evaluation of Cardiotoxicity of Anthracycline-Containing Chemotherapy Regimens in Patients with Bone and Soft Tissue Sarcomas: A Study of the FDA Adverse Event Reporting System Joint Single-Center Real-World Experience","volume":"12","author":"Mo","year":"2023","journal-title":"Cancer Med."},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Popa Ilie, I.R., Vonica-Tincu, A.L., Dobrea, C.M., Butuca, A., Frum, A., Morgovan, C., Gligor, F.G., and Ghibu, S. (2024). Safety Profiles Related to Dosing Errors of Rapid-Acting Insulin Analogs: A Comparative Analysis Using the EudraVigilance Database. Biomedicines, 12.","DOI":"10.3390\/biomedicines12102273"},{"key":"ref_19","unstructured":"(2026, July 18). Medical Dictionary for Regulatory Activities Introductory Guide MedDRA Version 28.1. Available online: https:\/\/alt.meddra.org\/files_acrobat\/intguide_28_1_English.pdf."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"20420986251401120","DOI":"10.1177\/20420986251401122","article-title":"Cardiotoxicity Associated with Antineoplastic Agents: A Pharmacovigilance Study Based on FDA Adverse Event Reporting System","volume":"16","author":"Qiu","year":"2025","journal-title":"Ther. Adv. Drug Saf."},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Buciuman, C.A., Dobrea, C.M., Butuca, A., Frum, A., Gligor, F.G., Gligor, O., Vica\u0219, L.G., and Morgovan, C. (2025). Exploring the Cardiovascular Safety Profile of Ibuprofen: Insights from EudraVigilance Database. Pharmaceuticals, 18.","DOI":"10.3390\/ph18071045"},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Popa Ilie, I.R., Dobrea, C.M., Butuca, A., Homorodean, C., Morgovan, C., Vonica-Tincu, A.L., Gligor, F.G., Ghibu, S., and Frum, A. (2024). Real-Life Data on the Safety of Pasireotide in Acromegaly: Insights from EudraVigilance. Pharmaceuticals, 17.","DOI":"10.3390\/ph17121631"},{"key":"ref_23","unstructured":"(2026, July 16). Serious Adverse Reaction|European Medicines Agency (EMA). Available online: https:\/\/www.ema.europa.eu\/en\/glossary-terms\/serious-adverse-reaction."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"627","DOI":"10.1007\/s00228-014-1658-1","article-title":"Reducing the Noise in Signal Detection of Adverse Drug Reactions by Standardizing the Background: A Pilot Study on Analyses of Proportional Reporting Ratios-by-Therapeutic Area","volume":"70","author":"Grundmark","year":"2014","journal-title":"Eur. J. Clin. Pharmacol."},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"Vonica, R.C., Butuca, A., Morgovan, C., Pumnea, M., Cipaian, R.C., Frum, A., Dobrea, C.M., Vonica-Tincu, A.L., Pacnejer, A.-M., and Ghibu, S. (2025). Bevacizumab\u2014Insights from EudraVigilance Database on the Assessments of the Safety Profile of Monoclonal Antibodies Used as Targeted Cancer Treatment. Pharmaceuticals, 18.","DOI":"10.3390\/ph18040501"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"1399","DOI":"10.1080\/14740338.2025.2461199","article-title":"Infectious Complications Associated with Immune and Targeted Anti-Cancer Therapies: A Retrospective Study of the FDA Adverse Events Reporting System (FAERS)","volume":"25","author":"Alsowaida","year":"2026","journal-title":"Expert Opin. Drug Saf."},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Popa Ilie, I.R., Ghibu, S., Butuca, A., Dobrea, C.M., Frum, A., Homorodean, C., Chis, A.A., and Morgovan, C. (2026). Incretin-Based Drugs for Obesity: Common and Drug-Specific Reporting Patterns of Adverse Drug Reactions\u2014A Comparative Disproportionality Analysis Using EudraVigilance Reports Integrating SmPC Data. Pharmaceuticals, 19.","DOI":"10.3390\/ph19060876"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"971","DOI":"10.1136\/heartjnl-2017-312103","article-title":"Anthracycline Cardiotoxicity: An Update on Mechanisms, Monitoring and Prevention","volume":"104","author":"Henriksen","year":"2018","journal-title":"Heart"},{"key":"ref_29","unstructured":"(2026, July 18). Pfizer Epirubicin Hydrochloride Injection I.P. Farmorubicin. Available online: https:\/\/labeling.pfizer.com\/ShowLabeling.aspx?id=15025."},{"key":"ref_30","unstructured":"(2026, July 18). Pfizer Product Information\u2014Adriamycin\u00ae (Doxorubicin Hydrochloride). Available online: https:\/\/labeling.pfizer.com\/ShowLabeling.aspx?id=12164."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"3267","DOI":"10.2174\/092986709788803312","article-title":"Doxorubicin: The Good, the Bad and the Ugly Effect","volume":"16","author":"Carvalho","year":"2009","journal-title":"Curr. Med. Chem."},{"key":"ref_32","first-page":"6128","article-title":"Global Pharmacovigilance Analysis of Epirubicin-Associated Cardiotoxicity: Real-World Insights from FAERS and EudraVigilance Databases (2004\u20132025)","volume":"6","author":"Hong","year":"2026","journal-title":"Curr. Sci."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1007\/s00428-021-03190-7","article-title":"Male Breast Cancer: An Update","volume":"480","author":"Fox","year":"2022","journal-title":"Virchows Arch."},{"key":"ref_34","doi-asserted-by":"crossref","unstructured":"Erdogmus Ozgen, Z., Asana, B., and Ozgen, M.M. (2025). Frequency of Adverse Drug Reactions in Cancer Patients: A Study at the Oncology Department of a University Hospital. J. Oncol. Pharm. Pract., 10781552251358171.","DOI":"10.1177\/10781552251358171"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"102","DOI":"10.1007\/s13346-024-01648-0","article-title":"Das A Comprehensive Review on Doxorubicin: Mechanisms, Toxicity, Clinical Trials, Combination Therapies and Nanoformulations in Breast Cancer","volume":"15","author":"Bisht","year":"2025","journal-title":"Drug Deliv. Transl. Res."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"252","DOI":"10.1177\/10781552221113578","article-title":"Adverse Drug Reactions Associated with Doxorubicin and Epirubicin: A Descriptive Analysis from VigiBase","volume":"32","author":"Matesun","year":"2026","journal-title":"J. Oncol. Pharm. Pract."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"807","DOI":"10.1124\/jpet.111.185892","article-title":"Oxidative Stress and Myocardial Gene Alterations Associated with Doxorubicin-Induced Cardiotoxicity in Rats Persist for 2 Months after Treatment Cessation","volume":"339","author":"Richard","year":"2011","journal-title":"J. Pharmacol. Exp. Ther."},{"key":"ref_38","doi-asserted-by":"crossref","unstructured":"Smith, L.A., Cornelius, V.R., Plummer, C.J., Levitt, G., Verrill, M., Canney, P., and Jones, A. (2010). Cardiotoxicity of Anthracycline Agents for the Treatment of Cancer: Systematic Review and Meta-Analysis of Randomised Controlled Trials. BMC Cancer, 10.","DOI":"10.1186\/1471-2407-10-337"},{"key":"ref_39","doi-asserted-by":"crossref","unstructured":"Guo, S., and Wong, S. (2014). Cardiovascular Toxicities from Systemic Breast Cancer Therapy. Front. Oncol., 4.","DOI":"10.3389\/fonc.2014.00346"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"38","DOI":"10.1097\/00000421-199102000-00009","article-title":"Weekly Epirubicin versus Doxorubicin as Second Line Therapy in Advanced Breast Cancer. A Randomized Clinical Trial","volume":"14","author":"Gasparini","year":"1991","journal-title":"Am. J. Clin. Oncol."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"818","DOI":"10.1200\/JCO.1985.3.6.818","article-title":"A Prospective Randomized Comparison of Epirubicin and Doxorubicin in Patients with Advanced Breast Cancer","volume":"3","author":"Jain","year":"1985","journal-title":"J. Clin. Oncol."},{"key":"ref_42","unstructured":"(2026, July 11). Benefit-Risk Balance for Medicinal Products. Available online: https:\/\/cioms.ch\/publications\/."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"301","DOI":"10.1016\/j.therap.2019.01.001","article-title":"Interest of Pharmacoepidemiology in Pharmacovigilance: Post-Authorization Safety Studies in Regulatory Pharmacovigilance Activity","volume":"74","author":"Ferard","year":"2019","journal-title":"Therapie"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1007\/s40264-024-01478-6","article-title":"Disproportionality Analysis and Characterisation of Medication Errors in EudraVigilance: Exploring Findings on Sexes and Age Groups","volume":"48","author":"Pera","year":"2024","journal-title":"Drug Saf."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"33278","DOI":"10.1038\/s41598-025-18383-2","article-title":"FAERS Based Disproportionality Analysis and Network Pharmacology Investigation of Doxorubicin Associated Drug Induced Cardiotoxicity","volume":"15","author":"Lu","year":"2025","journal-title":"Sci. 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