Association between baseline blood pressure and the incidence of lenvatinib-induced hypertension in patients with thyroid cancer

IF 2.9 2区医学 Q2 ONCOLOGY Cancer Medicine Pub Date : 2023-10-30 DOI:10.1002/cam4.6644

Yuma Shibutani, Kazuko Tajiri, Shinya Suzuki, Tomohiro Enokida, Atsunobu Sagara, Susumu Okano, Takao Fujisawa, Fumiaki Sato, Tetsuro Yumoto, Motohiko Sano, Toshikatsu Kawasaki, Makoto Tahara

{"title":"Association between baseline blood pressure and the incidence of lenvatinib-induced hypertension in patients with thyroid cancer","authors":"Yuma Shibutani, Kazuko Tajiri, Shinya Suzuki, Tomohiro Enokida, Atsunobu Sagara, Susumu Okano, Takao Fujisawa, Fumiaki Sato, Tetsuro Yumoto, Motohiko Sano, Toshikatsu Kawasaki, Makoto Tahara","doi":"10.1002/cam4.6644","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Background</h3>\n \n <p>Hypertension is the most frequently occurring adverse event of lenvatinib, recognized relatively early in its course. However, the trend in blood pressure after the initiation of lenvatinib and the outcomes with antihypertensive treatment are unclear. This study aimed to clarify the association between baseline blood pressure and the incidence of lenvatinib-induced hypertension in patients with thyroid cancer.</p>\n </section>\n \n <section>\n \n <h3> Method<b>s</b></h3>\n \n <p>This retrospective study included 65 patients without hypertension at the time of lenvatinib initiation. Patients were divided into two groups: those who developed hypertension grade ≥3 (HTN group) and those who did not develop hypertension grade ≥3 (non-HTN group).</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>Of the 65 patients, 46 (71%) developed hypertension grade ≥3. In both HTN and non-HTN groups, blood pressure significantly increased the day after lenvatinib initiation. There was no significant difference in the elevated values of both the changes in systolic blood pressure (ΔSBP) and diastolic blood pressure (ΔDBP) between the two groups, with an average increase of 20 mmHg in SBP and 13 mmHg in DBP from baseline. The median (range) time to the onset of hypertension grade ≥3 was 2 days (1–12 days). In the multivariable analysis, patients with normal (SBP 120–129 mmHg and/or DBP 80–84 mmHg) or high-normal baseline blood pressure (SBP 130–139 mmHg and/or DBP 85–89 mmHg) were at higher risk of developing hypertension grade ≥3 than those with optimal baseline blood pressure (SBP <120 mmHg and DBP <80 mmHg) (odds ratio [OR], 5.07; 95% confidential interval [CI] 1.09–23.54 and OR, 7.48; 95% CI, 1.67–33.51, respectively).</p>\n </section>\n \n <section>\n \n <h3> Conclusions</h3>\n \n <p>Lenvatinib-induced hypertension appears the day after administration, and higher baseline blood pressure is a significant risk factor for developing hypertension grade ≥3. In cases of increased blood pressure with lenvatinib, early initiation of antihypertensives may prevent treatment interruption due to hypertension and maintain the therapeutic intensity of lenvatinib.</p>\n </section>\n </div>","PeriodicalId":139,"journal":{"name":"Cancer Medicine","volume":"12 22","pages":"20773-20782"},"PeriodicalIF":2.9000,"publicationDate":"2023-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cam4.6644","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Cancer Medicine","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1002/cam4.6644","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"ONCOLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Background

Hypertension is the most frequently occurring adverse event of lenvatinib, recognized relatively early in its course. However, the trend in blood pressure after the initiation of lenvatinib and the outcomes with antihypertensive treatment are unclear. This study aimed to clarify the association between baseline blood pressure and the incidence of lenvatinib-induced hypertension in patients with thyroid cancer.

Methods

This retrospective study included 65 patients without hypertension at the time of lenvatinib initiation. Patients were divided into two groups: those who developed hypertension grade ≥3 (HTN group) and those who did not develop hypertension grade ≥3 (non-HTN group).

Results

Of the 65 patients, 46 (71%) developed hypertension grade ≥3. In both HTN and non-HTN groups, blood pressure significantly increased the day after lenvatinib initiation. There was no significant difference in the elevated values of both the changes in systolic blood pressure (ΔSBP) and diastolic blood pressure (ΔDBP) between the two groups, with an average increase of 20 mmHg in SBP and 13 mmHg in DBP from baseline. The median (range) time to the onset of hypertension grade ≥3 was 2 days (1–12 days). In the multivariable analysis, patients with normal (SBP 120–129 mmHg and/or DBP 80–84 mmHg) or high-normal baseline blood pressure (SBP 130–139 mmHg and/or DBP 85–89 mmHg) were at higher risk of developing hypertension grade ≥3 than those with optimal baseline blood pressure (SBP <120 mmHg and DBP <80 mmHg) (odds ratio [OR], 5.07; 95% confidential interval [CI] 1.09–23.54 and OR, 7.48; 95% CI, 1.67–33.51, respectively).

Conclusions

Lenvatinib-induced hypertension appears the day after administration, and higher baseline blood pressure is a significant risk factor for developing hypertension grade ≥3. In cases of increased blood pressure with lenvatinib, early initiation of antihypertensives may prevent treatment interruption due to hypertension and maintain the therapeutic intensity of lenvatinib.

Abstract Image

查看原文

微信好友朋友圈 QQ好友复制链接

本刊更多论文

癌症患者基线血压与乐伐替尼诱导的高血压发病率的相关性。

背景：高血压是乐伐替尼最常见的不良事件，在其病程中相对较早被发现。然而，乐伐替尼用药后的血压趋势以及降压治疗的结果尚不清楚。本研究旨在阐明癌症患者基线血压与乐伐替尼诱导的高血压发病率之间的关系。方法：本回顾性研究纳入了65例乐伐替尼用药时无高血压的患者。患者被分为两组：出现高血压分级的患者 ≥3（HTN组）和未出现高血压分级的患者 ≥结果：65例患者中，46例（71%）出现高血压分级 ≥3.在HTN组和非HTN组中，乐伐替尼给药后第二天血压均显著升高。两组的收缩压（ΔSBP）和舒张压（ΔDBP）的升高值均无显著差异，平均升高20 收缩压mmHg和13 DBP与基线相比为mmHg。高血压分级发病的中位（范围）时间 ≥3是2 天（1-12 天）。在多变量分析中，正常（SBP 120-129 mmHg和/或DBP 80-84 mmHg）或高正常基线血压（SBP 130-139 mmHg和/或DBP 85-89 mmHg）发生高血压分级的风险更高 ≥3比具有最佳基线血压的患者高（SBP结论：乐伐替尼诱导的高血压在给药后第二天出现，较高的基线血压是发展为高血压分级的重要风险因素 ≥3.在乐伐替尼导致血压升高的情况下，尽早开始服用抗高血压药物可以防止因高血压导致的治疗中断，并保持乐伐替尼克的治疗强度。

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

Cancer Medicine ONCOLOGY-

CiteScore

5.50

自引率

2.50%

发文量

907

审稿时长

19 weeks

期刊介绍： Cancer Medicine is a peer-reviewed, open access, interdisciplinary journal providing rapid publication of research from global biomedical researchers across the cancer sciences. The journal will consider submissions from all oncologic specialties, including, but not limited to, the following areas: Clinical Cancer Research Translational research ∙ clinical trials ∙ chemotherapy ∙ radiation therapy ∙ surgical therapy ∙ clinical observations ∙ clinical guidelines ∙ genetic consultation ∙ ethical considerations Cancer Biology: Molecular biology ∙ cellular biology ∙ molecular genetics ∙ genomics ∙ immunology ∙ epigenetics ∙ metabolic studies ∙ proteomics ∙ cytopathology ∙ carcinogenesis ∙ drug discovery and delivery. Cancer Prevention: Behavioral science ∙ psychosocial studies ∙ screening ∙ nutrition ∙ epidemiology and prevention ∙ community outreach. Bioinformatics: Gene expressions profiles ∙ gene regulation networks ∙ genome bioinformatics ∙ pathwayanalysis ∙ prognostic biomarkers. Cancer Medicine publishes original research articles, systematic reviews, meta-analyses, and research methods papers, along with invited editorials and commentaries. Original research papers must report well-conducted research with conclusions supported by the data presented in the paper.