Department of Pharmaceutical Medicine (Division of Pharmacology), School of Pharmaceutical Education and Research, Jamia Hamdard, New Delhi, India.
Department of Hemato-Oncology and BMT Unit, Rajiv Gandhi Cancer Institute and Research Centre, New Delhi, India.
Nephrology (Carlton). 2022 Apr;27(4):318-326. doi: 10.1111/nep.14014. Epub 2022 Jan 6.
Recently, multiple epidemiological studies have linked imatinib with the alteration of renal function in chronic myeloid leukaemia (CML) patients. This meta-analysis aimed to summarize the impact of imatinib use on renal function in CML patients.
A systematic search was conducted on MEDLINE and Embase to identify articles assessing the impact of imatinib exposure on renal function in CML patients. The risk of bias was assessed using the Newcastle-Ottawa scale (NOS). Two authors independently performed literature-screening, risk of bias and data extraction. The risk of renal dysfunction (chronic kidney disease or acute kidney injury) among imatinib users was computed as the primary outcome of interest. The certainty of findings was assessed using the grading of recommendations assessment, development and evaluation (GRADE) criteria.
A total of nine articles qualified for inclusion in the systematic review, of which four articles were eligible for meta-analysis. Based on the scoring on NOS, majority of the included studies were found to be of moderate risk of bias. Majority of the studies (n = 6) reported significantly (p < .05) decrease in estimated glomerular filtration rate (eGFR) after imatinib treatment. The risk of developing renal dysfunction (chronic kidney disease or acute kidney injury) was found to be significantly higher in imatinib users as compared to other tyrosine kinase inhibitor (TKI) users with a pooled relative risk of 2.70 (95% CI: 1.49-4.91). Sensitivity analysis also revealed a consistently high risk of renal dysfunction with imatinib use. GRADE criteria revealed low certainty of evidence.
This meta-analysis found an increased risk of renal dysfunction in imatinib users compared to other TKI users.
最近，多项流行病学研究表明伊马替尼与慢性髓性白血病（CML）患者肾功能改变有关。本荟萃分析旨在总结伊马替尼使用对 CML 患者肾功能的影响。
系统检索 MEDLINE 和 Embase 以确定评估伊马替尼暴露对 CML 患者肾功能影响的文章。使用纽卡斯尔-渥太华量表（NOS）评估偏倚风险。两名作者独立进行文献筛选、偏倚风险和数据提取。伊马替尼使用者肾功能障碍（慢性肾脏病或急性肾损伤）的风险作为主要研究终点。使用推荐评估、制定和评估（GRADE）标准评估证据确定性。
共有 9 篇文章符合系统评价纳入标准，其中 4 篇文章符合荟萃分析纳入标准。根据 NOS 评分，大多数纳入研究被认为存在中度偏倚风险。大多数研究（n=6）报告伊马替尼治疗后肾小球滤过率（eGFR）显著下降（p<.05）。与其他酪氨酸激酶抑制剂（TKI）使用者相比，伊马替尼使用者发生肾功能障碍（慢性肾脏病或急性肾损伤）的风险显著更高，合并相对风险为 2.70（95%CI：1.49-4.91）。敏感性分析也显示伊马替尼使用与肾功能障碍风险增加一致。GRADE 标准显示证据确定性低。
本荟萃分析发现与其他 TKI 使用者相比，伊马替尼使用者发生肾功能障碍的风险增加。
