Effect of erythropoiesis-stimulating agents on malignant neoplasms: FAERS database and Mendelian randomization.

IF 2.1 4区医学 Q2 HEMATOLOGY Expert Review of Hematology Pub Date : 2025-01-01 Epub Date: 2025-02-20 DOI:10.1080/17474086.2025.2468400

Cuilv Liang, Qiaohong Wang, Peihong Wang, Yin Zhang

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Abstract

Background: The relationship between erythropoiesis-stimulating agents (ESAs) and malignant neoplasms (MNs) has been controversial in previous studies. Our study aimed to explore the correlation between ESAs and MNs.

Research design and methods: Drug-target Mendelian randomization (MR) analyses were conducted to evaluate the causal associations of ESAs for 12 classifications of MNs. Meanwhile, a pharmacovigilance study was performed by extracting adverse events (AEs) from the FDA Adverse Event Reporting System (FAERS) database to validate and complement our findings. MR analysis revealed negative association of ESAs with MN of ovary (p = 0.047), liposarcoma (p = 0.001), small cell lung cancer (p = 0.017), colorectal cancer (p = 0.004), and brain meningioma (p = 0.004) and revealed positive association of ESAs with MN of bladder (p = 0.001), eye and adnexa (p = 0.012), heart, mediastinum, and pleura (p = 0.032), lip (p = 0.041), larynx (p = 0.015), non-small cell lung cancer (p = 0.009), and malignant melanoma (p = 0.001). Positive signals were found in MN of hematological system, digestive organs, central nervous system, eye and adnexa, head and neck cancer, lung cancer, and mucinous and mucinous cystic tumor in FAERS database (all reporting odds ratio and proportional reporting ratio >1).

Conclusion: ESAs were causally correlated with many types of MNs. The use of ESAs in these tumors needs more attention.

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促红细胞生成剂对恶性肿瘤的影响：FAERS数据库和孟德尔随机化。

背景：促红细胞生成素（ESAs）与恶性肿瘤（MNs）之间的关系在以往的研究中一直存在争议。本研究旨在探讨esa与MNs之间的相关性。研究设计和方法：采用药物靶孟德尔随机化（MR）分析，评价12种MNs分类中ESAs的因果关系。同时，通过提取FDA不良事件报告系统（FAERS）数据库中的不良事件（ae）进行药物警戒研究，以验证和补充我们的研究结果。MR分析显示，ESAs与卵巢MN （p = 0.047）、脂肪肉瘤（p = 0.001）、小细胞肺癌（p = 0.017）、结直肠癌（p = 0.004）、脑膜瘤（p = 0.004）呈负相关，与膀胱MN （p = 0.001）、眼附件MN （p = 0.012）、心脏、纵隔和胸膜MN （p = 0.032）、唇部MN （p = 0.041）、喉部MN （p = 0.015）、非小细胞肺癌MN （p = 0.009）、恶性黑色素瘤MN （p = 0.001）呈正相关。FAERS数据库中血液学系统、消化器官、中枢神经系统、眼附件、头颈癌、肺癌、黏液性和黏液性囊性肿瘤均有阳性信号（均报告优势比（ROR）和比例报告比（PRR） bb0.1）。结论：esa与多种类型的MNs存在因果关系。在这些肿瘤中使用esa需要更多的关注。

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

Expert Review of Hematology HEMATOLOGY-

CiteScore

4.70

自引率

3.60%

发文量

审稿时长

6-12 weeks

期刊介绍： Advanced molecular research techniques have transformed hematology in recent years. With improved understanding of hematologic diseases, we now have the opportunity to research and evaluate new biological therapies, new drugs and drug combinations, new treatment schedules and novel approaches including stem cell transplantation. We can also expect proteomics, molecular genetics and biomarker research to facilitate new diagnostic approaches and the identification of appropriate therapies. Further advances in our knowledge regarding the formation and function of blood cells and blood-forming tissues should ensue, and it will be a major challenge for hematologists to adopt these new paradigms and develop integrated strategies to define the best possible patient care. Expert Review of Hematology (1747-4086) puts these advances in context and explores how they will translate directly into clinical practice.