Matsumura Chikako, Chisaki Yugo, Sakimoto Satoko, Sakae Honoka, Yano Yoshitaka
Education and Research Center for Clinical Pharmacy, Kyoto Pharmaceutical University, Kyoto, Japan.
J Oncol Pharm Pract. 2018 Jan;24(1):22-27. doi: 10.1177/1078155216679025. Epub 2016 Nov 17.
Purpose We aimed to examine the risk factors, time of onset, incidence rates, and outcomes of thromboembolic events induced by bevacizumab in patients with cancer using the Japanese Adverse Drug Event Report (JADER) database of the Pharmaceuticals and Medical Devices Agency. Methods Adverse event data recorded in the JADER database between January 2004 and January 2015 were used. After screening the data using the generic drug name bevacizumab, patient data were classified into two groups by age and five groups by cancer type. The histories of disorders were also categorized. Arterial thromboembolic event and venous thromboembolic event were classified as "favorable" or "unfavorable" outcomes. Results In total, 6076 patients were reported to have developed adverse events during the sample period, of which 233 and 453 developed arterial thromboembolic event and venous thromboembolic event, respectively. Logistic analysis suggested that the presence of cancer was a significant risk factor for both arterial thromboembolic event and venous thromboembolic event. Age (≥70 years), histories of either hypertension or diabetes mellitus were also risk factors for arterial thromboembolic event. Median cumulative times of onset for arterial thromboembolic event and venous thromboembolic event were 60 and 80 days, respectively, and were not significantly different by the log-rank test. By the chi-square test, the rate of unfavorable outcomes was found to be higher after developing arterial thromboembolic event than after venous thromboembolic event. Conclusion Thromboembolism is a leading cause of mortality in patients with cancer. Patients should be monitored for the symptoms of thromboembolic events right from the initial stages of bevacizumab treatment.
目的 我们旨在利用日本药品和医疗器械管理局的不良药物事件报告(JADER)数据库,研究贝伐单抗诱导癌症患者发生血栓栓塞事件的危险因素、发病时间、发病率及转归。方法 使用2004年1月至2015年1月JADER数据库中记录的不良事件数据。在使用通用名贝伐单抗筛选数据后,患者数据按年龄分为两组,按癌症类型分为五组。还对疾病史进行了分类。动脉血栓栓塞事件和静脉血栓栓塞事件被分类为“良好”或“不良”转归。结果 在样本期内,总共报告有6076例患者发生不良事件,其中分别有233例和453例发生动脉血栓栓塞事件和静脉血栓栓塞事件。逻辑分析表明,癌症的存在是动脉血栓栓塞事件和静脉血栓栓塞事件的重要危险因素。年龄(≥70岁)、高血压或糖尿病病史也是动脉血栓栓塞事件的危险因素。动脉血栓栓塞事件和静脉血栓栓塞事件的中位累积发病时间分别为60天和80天,经对数秩检验无显著差异。通过卡方检验发现,发生动脉血栓栓塞事件后不良转归的发生率高于发生静脉血栓栓塞事件后。结论 血栓栓塞是癌症患者死亡的主要原因。从贝伐单抗治疗的初始阶段就应对患者进行血栓栓塞事件症状的监测。