Corticosteroid-Associated Hiccups: Characteristics and Disproportionality Analysis from VigiBase, the WHO Pharmacovigilance Database

Background: The occurrence of hiccups has been described for several drugs, including corticosteroids. However, comprehensive pharmacovigilance data on corticosteroid-associated hiccups are limited. Objectives: This study aimed to characterize reports of corticosteroid-associated hiccups and identify disproportionate reporting signals using VigiBase, the World Health Organization (WHO) global pharmacovigilance database. Methods: A retrospective case/non-case pharmacovigilance study was performed using individual case safety reports (ICSRs) recorded in VigiBase. Reports containing a corticosteroid classified as “suspected” or “interacting” and the MedDRA Preferred Term “Hiccups” were identified. Both drug roles were included because they indicate that the drug was considered potentially relevant to the reported adverse event, whereas “concomitant” drugs were not. Demographic characteristics, time to onset, outcomes, and dechallenge and rechallenge information were analyzed. Disproportionality was assessed using the Bayesian Information Component (IC), with a positive IC0.25 indicating a disproportionate reporting signal. Results: A total of 6543 ICSRs, comprising 6642 drug–reaction pairs were analyzed. Most reports involved males (91.6%) and originated from Asia (79.4%). Hiccups occurred most frequently on the same day as corticosteroid administration (38.3%), followed by day one (24.9%) and day two (12.4%). Most outcomes were reported as “recovered” (51.7%) or “recovering” (28.3%). Nineteen corticosteroids or corticosteroid-containing drug combinations showed a disproportionate reporting signal. Dexamethasone was the most frequently reported corticosteroid (N = 4903) and showed the strongest signal (IC0.25 = 6.0). Conclusions: Corticosteroid-associated hiccups were reported predominantly in males and typically occurred within the first day. Nineteen corticosteroids demonstrated disproportionate reporting signals, with dexamethasone showing the strongest association. Increased awareness of this adverse effect may facilitate timely recognition and management, while further studies are needed to clarify underlying mechanisms and patient-specific susceptibility factors.