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Majed S Al Yami,1,2 Mohammed Y Alzahrani,1,2 Abdulmajeed M Alshehri,1,2 Omar A Alshaya,1,2 Norah S Alsubiae,1 Yazeed M Alharbi,1 Latifah K Albaiahy,1 Mounira Aldeiban,1 Haya A Alkuait,3 Wejdan Alobaidi,4 Anas Aldawsari,5 Nouf M Almutairi,6 Mohannad Alshibani,7 Ghazwa B Korayem,8 Osamah M Alfayez,9 Abdulaali R Almutairi,10 Omar A Almohammed11 1Department of Pharmacy Practice, College of Pharmacy, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia; 2King Abdullah International Medical Research Center, Riyadh, Saudi Arabia; 3Sales Department, SPIMACO Addwaeih, Riyadh, Saudi Arabia; 4Sales Department,Novo Nordisk, Riyadh, Saudi Arabia; 5Sales Department,Sanofi, Riyadh, Saudi Arabia; 6Sales Department, BAYER Pharmaceutical, Riyadh, Saudi Arabia; 7Department of Pharmacy Practice, Faculty of Pharmacy, King Abdulaziz University, Jeddah, Saudi Arabia; 8Department of Pharmacy Practice, College of Pharmacy, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia; 9Department of Pharmacy Practice, College of Pharmacy, Qassim University, Qassim, Saudi Arabia; 10Drug Sector, Saudi Food and Drug Authority, Riyadh, Saudi Arabia; 11Department of Clinical Pharmacy, College of Pharmacy, King Saud University, Riyadh, Saudi ArabiaCorrespondence: Ghazwa B KorayemPharmacy Practice Department, College of Pharmacy, Princess Nourah bint Abdulrahman University, Al Imam Abdullah Ibn Saud Ibn Abdul Aziz Road, Riyadh, Saudi ArabiaTel +966 504161649Email Gbkorayem@pnu.edu.saPurpose: The main objective of this study was to evaluate the effectiveness and safety of apixaban versus warfarin in patients with venous thromboembolism (VTE) in a “real-world” setting.Patients and Methods: A retrospective cohort study was conducted using data from a large tertiary hospital in Saudi Arabia. Patients were included if they were adults (≥ 18 years), diagnosed with VTE, and treated with either apixaban or warfarin between January 2016 and September 2018. Patients who had

(1): Background: The use of ipilimumab, nivolumab, and pembrolizumab as monotherapies or in combination has transformed the management of advanced melanoma even though these drugs are associated with a new profile of immune-related adverse events (irAEs). The incidence of irAEs from clinical trials of these agents is an important factor for clinicians when treating patients with advanced melanoma. In the current study, we aimed to profile the incidence of potential irAEs of these agents when used as monotherapy and as combination therapy. Methods: We searched the Medline, Embase, and Cochrane databases; clinicaltrials.gov; and websites of regulatory agencies in the USA, Europe, Australia, and Japan for phase 1-3 trials of ipilimumab, nivolumab, and pembrolizumab for advanced melanoma. Random effect meta-analysis was utilized to profile the incidence of potential irAEs. Results: A total of 58 reports of 35 trials including 6331 patients with advanced melanoma and reporting irAE data were included in the meta-analyses. We found higher incidences of potential irAEs in combination therapies versus monotherapies for most of the types of irAEs. Among the monotherapies, ipilimumab users had the most frequent incidence of potential irAEs related to the gastrointestinal system (diarrhea, 29%; and colitis, 8%) and skin (rash, 31%; pruritus, 27%; and dermatitis, 10%), with hypophysitis in 4% of the patients. The most frequent potential irAEs among nivolumab users were maculopapular rash (13%), erythema (4%), hepatitis (3%), and infusion-related reactions (3%), while they were arthralgia (12%), hypothyroidism (8%), and hyperglycemia (6%) among pembrolizumab users. Conclusion: Especially the combination therapies tend to elevate the incidence of potential irAEs. Clinicians should be vigilant about irAEs following combination therapy as well as gastrointestinal and skin irAEs following ipilimumab therapy, in addition to being aware of potential irAEs leading to hyperglyc