Complex dyslipidemia induced by Lorlatinib therapy: A case study.

IF 3.6 3区医学 Q2 PHARMACOLOGY & PHARMACY Journal of clinical lipidology Pub Date : 2024-10-17 DOI:10.1016/j.jacl.2024.10.003

Julianna West, Abhimanyu Garg

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Abstract

Context: Lorlatinib is an anaplastic lymphoma kinase (ALK) inhibitor, which is currently used for the treatment of ALK-positive metastatic non-small cell lung cancer (NSCLC). Previous reports have noticed an association between lorlatinib and hyperlipidemia, however the specific mechanisms for this side effect remain unknown. Some investigators have reported nephrotic syndrome to be the underlying cause of lorlatinib-induced hyperlipidemia.

Case report: A 59-year-old female with NSCLC presented with marked elevation of lipid levels, including total cholesterol, triglycerides, low-density lipoprotein-cholesterol (LDL-C), and high-density lipoprotein-cholesterol (HDL-C), after initiation of lorlatinib therapy. Despite high dose atorvastatin and ezetimibe, lipid levels remained elevated. A 24-hour urine collection revealed only 226 mg of protein excretion.

Conclusions: Lorlatinib induced a complex dyslipidemia in our patient with elevations of both LDL-C and HDL-C. The underlying mechanism of lorlatinib-induced hyperlipidemia remains unknown and is unlikely to be secondary to nephrotic syndrome in many patients.

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罗拉替尼治疗诱发的复杂血脂异常：病例研究。

背景：洛拉替尼是一种无性淋巴瘤激酶（ALK）抑制剂，目前用于治疗ALK阳性转移性非小细胞肺癌（NSCLC）。以前的报告注意到了洛拉替尼与高脂血症之间的关联，但这种副作用的具体机制仍不清楚。一些研究者报告称，肾病综合征是洛拉替尼诱发高脂血症的根本原因：病例报告：一名59岁的女性NSCLC患者在开始接受洛拉替尼治疗后出现血脂水平明显升高，包括总胆固醇、甘油三酯、低密度脂蛋白胆固醇（LDL-C）和高密度脂蛋白胆固醇（HDL-C）。尽管服用了大剂量阿托伐他汀和依泽替米贝，血脂水平仍然升高。24小时尿液收集结果显示，蛋白质排泄量仅为226毫克：结论：洛拉替尼在我们的患者中诱发了复杂的血脂异常，低密度脂蛋白胆固醇（LDL-C）和高密度脂蛋白胆固醇（HDL-C）均升高。洛拉替尼诱发高脂血症的根本机制尚不清楚，许多患者不太可能继发于肾病综合征。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of clinical lipidology 医学-药学

CiteScore

7.00

自引率

6.80%

发文量

209

审稿时长

49 days

期刊介绍： Because the scope of clinical lipidology is broad, the topics addressed by the Journal are equally diverse. Typical articles explore lipidology as it is practiced in the treatment setting, recent developments in pharmacological research, reports of treatment and trials, case studies, the impact of lifestyle modification, and similar academic material of interest to the practitioner. While preference is given to material of immediate practical concern, the science that underpins lipidology is forwarded by expert contributors so that evidence-based approaches to reducing cardiovascular and coronary heart disease can be made immediately available to our readers. Sections of the Journal will address pioneering studies and the clinicians who conduct them, case studies, ethical standards and conduct, professional guidance such as ATP and NCEP, editorial commentary, letters from readers, National Lipid Association (NLA) news and upcoming event information, as well as abstracts from the NLA annual scientific sessions and the scientific forums held by its chapters, when appropriate.