Background Pharmacological inhibition of angiogenesis via the
vascular endothelial growth factor pathway is an important therapeutic target that prevents
tumor growth and the formation of
metastases. Although
vascular endothelial growth factor inhibitor (VPI) is well understood as a well-defined safety profile, few real-world studies are comparing the incidence, clinical features, and prognosis of the
aneurysm and
artery dissection. Methods and Results To evaluate and compare the links between different VPIs and
aneurysm and
artery dissection, we identified 634 reports with VPIs in the US Food and Drug Administration Adverse Event Reporting System database ranging between January 2004 to March 2020. We used the reporting odds ratio for the association between the use of VPIs and
aneurysm and
artery dissection. The reporting odds ratio (3.68, 95%, 2.18‒6.23) shows that
ramucirumab has a stronger correlation than other VPIs. The results show a significant difference in onset time (P<0.001). The median time to
aneurysm and
artery dissection was 79.5 (interquartile interval, 19.0-273.5) days after VPI administration. The results also show that VPI-associated
aneurysm and
artery dissection was reported more often in men (n=336, 59.68% versus n=227, 40.32%), and there were more cases in patients aged between 45 to 74 years than those <45 years (n=312, 68.12% versus n=18, 3.93%); patients aged ≥75 years accounted for 27.95% (n=128). Finally, the suspected drugs generally led to 19.98% deaths and 29.81% hospitalizations. Conclusions We identified signals for
aneurysm and
artery dissection following various VPIs in real-world practice via the Food and Drug Administration Adverse Event Reporting System, which represents the first step for continued pharmacovigilance investigation.