血管内皮生长因子受体酪氨酸激酶抑制剂的肝毒性：一项随机临床试验的荟萃分析。
Hepatotoxicity with vascular endothelial growth factor receptor tyrosine kinase inhibitors: A meta-analysis of randomized clinical trials.
机构信息
Department of Internal Medicine, University of Alabama at Birmingham (UAB), AL, United States.
Department of Food and Nutrition, Kyung Hee University, Seoul, Republic of Korea.
出版信息
Crit Rev Oncol Hematol. 2015 Mar;93(3):257-76. doi: 10.1016/j.critrevonc.2014.11.006. Epub 2014 Nov 27.
A meta-analysis of randomized controlled trials (RCT) was conducted to determine the relative risk (RR) of hepatotoxicity with vascular endothelial growth factor receptor (VEGFR) tyrosine kinase inhibitors (TKI). Citations from PubMed/Medline, abstracts from major conferences, clinicaltrials.gov and package inserts were reviewed to include RCTs comparing arms with or without a VEGFR TKI. The RRs of all-grade ALT, AST, ALP and bilirubin elevation in 18,282 patients from 52 trials were 1.57 (95% CI 1.38-1.79, p<0.001), 1.57 (95% CI 1.36-1.81, p<0.001), 1.20 (95% CI 1.09-1.83, p<0.001) and 1.55 (95% CI 1.21-1.97, p<0.001) respectively, and high-grade elevations were 1.66 (95% CI 1.25-2.20, p=0.001), 1.61 (95% CI 1.21-2.14, p=0.001), 1.02 (95% CI 0.70-1.47, p=0.932) and 1.34 (95% CI 1.0-1.81, p=0.054) respectively compared to those in the non-TKI group. The incidence of hepatic failure with VEGFR TKIs was 0.8%.
进行了一项随机对照试验 (RCT) 的荟萃分析，以确定血管内皮生长因子受体 (VEGFR) 酪氨酸激酶抑制剂 (TKI) 引起肝毒性的相对风险 (RR)。从 PubMed/Medline 中检索文献、主要会议摘要、clinicaltrials.gov 和说明书中进行了检索，纳入了比较使用和未使用 VEGFR TKI 的治疗组的 RCT。52 项试验中，18282 例患者中所有级别 ALT、AST、ALP 和胆红素升高的 RR 分别为 1.57（95%CI 1.38-1.79，p<0.001）、1.57（95%CI 1.36-1.81，p<0.001）、1.20（95%CI 1.09-1.83，p<0.001）和 1.55（95%CI 1.21-1.97，p<0.001），而高级别升高的 RR 分别为 1.66（95%CI 1.25-2.20，p=0.001）、1.61（95%CI 1.21-2.14，p=0.001）、1.02（95%CI 0.70-1.47，p=0.932）和 1.34（95%CI 1.0-1.81，p=0.054）。与非 TKI 组相比，VEGFR TKI 相关肝衰竭的发生率为 0.8%。
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