Incidence and Management of Carfilzomib-induced Cardiovascular Toxicity; A Systematic Review and Meta-analysis.

Q2 Medicine Cardiovascular and Hematological Disorders - Drug Targets Pub Date : 2021-01-01 DOI:10.2174/1871529X21666210412113017

Azka Latif, Vikas Kapoor, Noman Lateef, Muhammad J Ahsan, Rana M Usman, Saad U Malik, Naqib Ahmad, Nathaniel Rosko, Joslyn Rudoni, Preethi William, Jack Khouri, Faiz Anwer

{"title":"Incidence and Management of Carfilzomib-induced Cardiovascular Toxicity; A Systematic Review and Meta-analysis.","authors":"Azka Latif, Vikas Kapoor, Noman Lateef, Muhammad J Ahsan, Rana M Usman, Saad U Malik, Naqib Ahmad, Nathaniel Rosko, Joslyn Rudoni, Preethi William, Jack Khouri, Faiz Anwer","doi":"10.2174/1871529X21666210412113017","DOIUrl":null,"url":null,"abstract":"Background: The ASPIRE and ENDEAVOUR trials have shown cardiovascular adverse effects in patients treated with carfilzomib-based regimens. Therefore, we conducted this meta- analysis of published clinical trials to identify the cumulative incidence and risk of cardiovascular adverse effects due to carfilzomib.Methods: A systematic search of PubMed, Embase, Web of Science, and Cochrane library was performed, and we identified 45 prospective trials of carfilzomib with data on 5583 patients. Among all patients being treated with carfilzomib (N=5,583), 8.9% sustained all grade cardiotoxicity, while 4.4% sustained high-grade cardiotoxicity. All-grade hypertension was present in 13.2%, while the incidence of high-grade hypertension was 5.3%.Results: The observed incidences of all-grade heart failure, edema, and ischemia were 5.1%, 20.7%, and 4.6%, respectively. Likewise, for high-grade heart failure and edema observed incidence was 3.2%, and 2.7%, respectively. There was no difference in the event rate of all and highgrade cardiotoxicity between newly diagnosed multiple myeloma and relapsed/refractory (p-value 0.42 and 0.86, respectively). Likewise, we did not observe any difference in the event rate of all and high-grade cardiotoxicity when carfilzomib was used as a single agent versus when used in combination therapy with other agents (p-value 0.43 and 0.73, respectively).Conclusion: Carfilzomib is associated with a significant risk of cardiovascular toxicity and hypertension. With the increasing utilization of carfilzomib, it is critical for primary care physicians, oncologists and cardiologists to be aware of the risk of cardiotoxicity associated with the use of carfilzomib to recognize and treat baseline cardiovascular risk factors in such patients.","PeriodicalId":9543,"journal":{"name":"Cardiovascular and Hematological Disorders - Drug Targets","volume":"21 1","pages":"30-45"},"PeriodicalIF":0.0000,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"10","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Cardiovascular and Hematological Disorders - Drug Targets","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.2174/1871529X21666210412113017","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"Medicine","Score":null,"Total":0}

引用次数: 10

Abstract

Background: The ASPIRE and ENDEAVOUR trials have shown cardiovascular adverse effects in patients treated with carfilzomib-based regimens. Therefore, we conducted this meta- analysis of published clinical trials to identify the cumulative incidence and risk of cardiovascular adverse effects due to carfilzomib.

Methods: A systematic search of PubMed, Embase, Web of Science, and Cochrane library was performed, and we identified 45 prospective trials of carfilzomib with data on 5583 patients. Among all patients being treated with carfilzomib (N=5,583), 8.9% sustained all grade cardiotoxicity, while 4.4% sustained high-grade cardiotoxicity. All-grade hypertension was present in 13.2%, while the incidence of high-grade hypertension was 5.3%.

Results: The observed incidences of all-grade heart failure, edema, and ischemia were 5.1%, 20.7%, and 4.6%, respectively. Likewise, for high-grade heart failure and edema observed incidence was 3.2%, and 2.7%, respectively. There was no difference in the event rate of all and highgrade cardiotoxicity between newly diagnosed multiple myeloma and relapsed/refractory (p-value 0.42 and 0.86, respectively). Likewise, we did not observe any difference in the event rate of all and high-grade cardiotoxicity when carfilzomib was used as a single agent versus when used in combination therapy with other agents (p-value 0.43 and 0.73, respectively).

Conclusion: Carfilzomib is associated with a significant risk of cardiovascular toxicity and hypertension. With the increasing utilization of carfilzomib, it is critical for primary care physicians, oncologists and cardiologists to be aware of the risk of cardiotoxicity associated with the use of carfilzomib to recognize and treat baseline cardiovascular risk factors in such patients.

查看原文

微信好友朋友圈 QQ好友复制链接

本刊更多论文

卡非佐米致心血管毒性的发生率及处理系统回顾和荟萃分析。

背景:ASPIRE和奋进试验显示，以卡非佐米为基础的方案治疗的患者心血管不良反应。因此，我们对已发表的临床试验进行了荟萃分析，以确定卡非佐米引起的心血管不良反应的累积发生率和风险。方法:系统检索PubMed, Embase, Web of Science和Cochrane图书馆，我们确定了45项carfilzomib前瞻性试验，数据来自5583例患者。在所有接受卡非佐米治疗的患者中(N=5,583)， 8.9%持续所有级别的心脏毒性，而4.4%持续高度的心脏毒性。全级别高血压的发生率为13.2%，而高级别高血压的发生率为5.3%。结果:观察到各级别心力衰竭、水肿和缺血的发生率分别为5.1%、20.7%和4.6%。同样，高度心力衰竭和水肿的发生率分别为3.2%和2.7%。在新诊断的多发性骨髓瘤和复发/难治性骨髓瘤之间，所有和高度心脏毒性的发生率没有差异(p值分别为0.42和0.86)。同样，我们没有观察到当卡非佐米作为单一药物与与其他药物联合使用时，所有和高度心脏毒性的发生率有任何差异(p值分别为0.43和0.73)。结论:卡非佐米与心血管毒性和高血压的显著风险相关。随着卡非佐米使用的增加，对于初级保健医生、肿瘤学家和心脏病专家来说，认识到与使用卡非佐米相关的心脏毒性风险，以识别和治疗这类患者的基线心血管危险因素至关重要。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文去求助

来源期刊

Cardiovascular and Hematological Disorders - Drug Targets Medicine-Cardiology and Cardiovascular Medicine

CiteScore

1.90

自引率

0.00%

发文量

期刊介绍： Cardiovascular & Hematological Disorders - Drug Targets aims to cover all the latest and outstanding developments on the medicinal chemistry, pharmacology, molecular biology, genomics and biochemistry of contemporary molecular targets involved in cardiovascular and hematological disorders e.g. disease specific proteins, receptors, enzymes, genes. Each issue of the journal contains a series of timely in-depth reviews written by leaders in the field covering a range of current topics on drug targets involved in cardiovascular and hematological disorders. As the discovery, identification, characterization and validation of novel human drug targets for cardiovascular and hematological drug discovery continues to grow.