Cardiovascular events in eGFR-mutation non-small-cell lung cancer patients on osimertinib.

IF 1.6 4区 医学 Q3 PHARMACOLOGY & PHARMACY European journal of hospital pharmacy : science and practice Pub Date : 2024-11-01 DOI:10.1136/ejhpharm-2024-004319
Samuel Akaakole Mensah, Syed Ahmad, Waleed Alruwaili, Rutu Raval, Karthik Gonuguntla, Brijesh Patel
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Abstract

Objectives: There have been cases of cardiotoxicity induced by osimertinib in patients with non-small-cell lung cancer (NSCLC). However, limited data exist for a comprehensive cardiotoxicity profile analysis for osimertinib use in NSCLC patients. The aim of this study was to report the entire profile of cardiotoxicities after the initiation of osimertinib in consecutive patients with epidermal growth factor receptor (EGFR) mutation at a single health system.

Methods: The data were retrospectively collected from electronic medical records for all patients who were started on osimertinib for NSCLC at West Virginia University Health System. Prevalence of heart failure (HF), atrial fibrillation, and prolonged QT before and after starting osimertinib were calculated.

Results: This study had 116 participants and the median age was 72 years. The frequency of each new cardiotoxicity was between 6% and 9%, and the overall percentage of patients who had developed any of the four cardiotoxicities while on osimertinib was 19.9%. The median time of follow-up was 477 days and the median time on osimertinib for all patients was 390 days. The strongest risk factor in predicting a new onset cardiac event was hypertension with a hazard ratio (HR) of 6.35 (confidence interval (CI) 1.48 to 27.23, p=0.013) and HR 5.36 (CI 1.23 to 23.39, p=0.025) in univariate and multivariate analysis respectively.

Conclusion: Osimertinib appears to be associated with an increase in cardiac abnormalities. Given the association between this medication exposure and the observed cardiac toxicities, use of osimertinib may entail closer cardiac monitoring of electrocardiogram (ECG) and echocardiogram abnormalities.

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估计肾小球滤过率突变的非小细胞肺癌患者服用奥希替尼后的心血管事件。
研究目的在非小细胞肺癌(NSCLC)患者中,曾有奥希替尼诱发心脏毒性的病例。然而,对 NSCLC 患者使用奥希替尼的心脏毒性概况进行全面分析的数据有限。本研究旨在报告一个医疗系统中估计肾小球滤过率(EGFR)突变的连续患者开始使用奥希替尼后心脏毒性的整个概况:方法:从西弗吉尼亚大学医疗系统所有开始使用奥希替尼治疗 NSCLC 的患者的电子病历中回顾性收集数据。计算了开始使用奥希替尼前后心力衰竭(HF)、心房颤动和QT延长的发生率:本研究共有 116 名参与者,中位年龄为 72 岁。每种新的心脏毒性发生率在6%至9%之间,在服用奥希替尼期间出现四种心脏毒性中任何一种的患者总比例为19.9%。中位随访时间为477天,所有患者服用奥希替尼的中位时间为390天。预测新发心脏事件的最强风险因素是高血压,单变量和多变量分析的危险比(HR)分别为6.35(置信区间(CI)1.48至27.23,P=0.013)和HR 5.36(CI 1.23至23.39,P=0.025):奥希替尼似乎与心脏异常的增加有关。结论:奥希莫替尼似乎与心脏异常的增加有关。鉴于这种药物暴露与观察到的心脏毒性之间的关联,使用奥希莫替尼可能需要对心电图(ECG)和超声心动图异常进行更密切的心脏监测。
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来源期刊
CiteScore
3.40
自引率
5.90%
发文量
104
审稿时长
6-12 weeks
期刊介绍: European Journal of Hospital Pharmacy (EJHP) offers a high quality, peer-reviewed platform for the publication of practical and innovative research which aims to strengthen the profile and professional status of hospital pharmacists. EJHP is committed to being the leading journal on all aspects of hospital pharmacy, thereby advancing the science, practice and profession of hospital pharmacy. The journal aims to become a major source for education and inspiration to improve practice and the standard of patient care in hospitals and related institutions worldwide. EJHP is the only official journal of the European Association of Hospital Pharmacists.
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