Department of Hematology, First People's Hospital of Foshan, Foshan, China.
Department of Internal Medicine, Foshan Maternal and Child Health Hospital, Foshan, China.
Drug Chem Toxicol. 2022 Jul;45(4):1443-1448. doi: 10.1080/01480545.2020.1835945. Epub 2020 Oct 27.
Prolonged survival and expanded treatment options in myeloma patients have led to adverse events associated with treatment getting increased attention. This systematic review and meta-analysis aimed to determine the incidence of ixazomib-associated cardiovascular adverse events (CVAEs) and to compare the rates of ixazomib-associated CVAEs and related therapies. CVAEs were defined as heart failure, hypertension, ischemia, and arrhythmia. All-grade and high-grade CVAEs and study characteristics were recorded. A total of 266 potentially relevant articles were identified, and 246 were excluded after review. Twenty studies of 1715 patients with multiple myeloma were thus considered in this study. The estimated rates of all-grade and high-grade ixazomib associated CVAEs were 11.2 and 3.7%, respectively. Subgroup analysis showed that median age ≥65 years, none phase 1 trial and combination regimen were associated with higher rates of high-grade ixazomib associated CVAEs. Ixazomib was association with increased high-grade CVAEs risk (RR = 1.679, 95% CI: 1.078-2.615, = 0.022). Ixazomib was associated with a significant rate of high-grade CVAEs. Future studies are needed to identify patients at high risk for high-grade CVAEs.
多发性骨髓瘤患者的生存时间延长和治疗选择的扩大导致与治疗相关的不良事件受到越来越多的关注。本系统评价和荟萃分析旨在确定依沙佐米相关心血管不良事件（CVAEs）的发生率，并比较依沙佐米相关 CVAEs 及相关治疗的发生率。CVAEs 定义为心力衰竭、高血压、缺血和心律失常。记录所有级别和高级别 CVAEs 及研究特征。共确定了 266 篇潜在相关文章，经审查后排除了 246 篇。因此，本研究共纳入了 20 项涉及 1715 例多发性骨髓瘤患者的研究。依沙佐米相关所有级别和高级别 CVAEs 的估计发生率分别为 11.2%和 3.7%。亚组分析显示，中位年龄≥65 岁、无 1 期试验和联合治疗方案与高级别依沙佐米相关 CVAEs 的发生率较高相关。依沙佐米与较高的高级别 CVAEs 风险相关（RR=1.679，95%CI：1.078-2.615，=0.022）。依沙佐米与较高的高级别 CVAEs 发生率相关。需要进一步的研究来确定高危患者的高级别 CVAEs。
