Department of Internal Medicine, Beth Israel Medical Center, University Hospital and Manhattan Campus for the Albert Einstein College of Medicine, New York, NY, USA.
J Hum Hypertens. 2013 Oct;27(10):601-11. doi: 10.1038/jhh.2013.30. Epub 2013 May 2.
Sorafenib, a multi-kinase inhibitor, has been reported to be associated with hypertension (HTN). However, the risk of severe HTN with sorafenib treatment has not been well described. We performed an up-to-date meta-analysis of high-grade HTN in cancer patients treated with sorafenib. Medline databases and the American Society of Clinical Oncology online database of meeting abstracts were searched up to August 2012 for relevant clinical trials. Eligible studies included phase II and III trials of sorafenib in patients with any type of cancer describing events of HTN according to the Common Terminology Criteria for Adverse Events. The summary incidence, relative risk (RR), and 95% confidence intervals (CIs) were calculated. The incidence of sorafenib-associated high-grade (grade 3-4) HTN was 6.0% (95% CI 4.7-7.3) in a total of 4722 patients from 55 trials of sorafenib as a single agent. Sorafenib-treated patients (4878 subjects from 13 randomized trials) had a significantly higher risk of high-grade HTN (RR 3.20 (95% CI 2.19-4.68)). Subgroup analysis revealed a significantly higher RR of high-grade HTN in patients receiving sorafenib as a single agent compared with patients receiving concomitant chemotherapy or immunotherapy (P=0.0076). The incidence of high-grade HTN associated with sorafenib was significantly higher in patients with renal cell carcinoma (RCC) than those with non-RCC cancer (P<0.0001) as well as patients treated with sorafenib for a longer duration than those treated for a shorter duration (P=0.003). The use of sorafenib is associated with a significantly higher risk of high-grade HTN compared with control.
索拉非尼是一种多激酶抑制剂，已被报道与高血压（HTN）有关。然而，索拉非尼治疗相关的严重 HTN 风险尚未得到很好的描述。我们对接受索拉非尼治疗的癌症患者中重度 HTN 进行了最新的荟萃分析。检索了截至 2012 年 8 月的 Medline 数据库和美国临床肿瘤学会在线会议摘要数据库，以寻找相关的临床试验。符合条件的研究包括描述根据常见不良事件术语标准发生 HTN 的任何类型癌症患者的索拉非尼 II 期和 III 期试验。计算了发生率、相对风险（RR）和 95%置信区间（CI）的汇总。来自 55 项索拉非尼单药治疗试验的 4722 例患者中，索拉非尼相关的重度（3-4 级）HTN 的发生率为 6.0%（95%CI 4.7-7.3）。来自 13 项随机试验的 4878 例索拉非尼治疗患者发生重度 HTN 的风险显著增加（RR 3.20 [95%CI 2.19-4.68]）。亚组分析显示，与接受联合化疗或免疫治疗的患者相比，接受索拉非尼单药治疗的患者发生重度 HTN 的 RR 显著更高（P=0.0076）。与非肾细胞癌（RCC）癌症患者相比，RCC 患者接受索拉非尼治疗发生重度 HTN 的发生率明显更高（P<0.0001），与接受较短疗程治疗的患者相比，接受较长疗程治疗的患者发生重度 HTN 的发生率明显更高（P=0.003）。与对照组相比，使用索拉非尼与发生重度 HTN 的风险显著增加相关。
