Vascular Risk Unit, Internal Medicine, Virgen de Las Nieves Hospital, Avenida de Las Fuerzas Armadas 2, 18014, Granada, Spain.
Hematology, Virgen de Las Nieves Hospital, Granada, Spain.
Sci Rep. 2023 Jul 21;13(1):11781. doi: 10.1038/s41598-023-39057-x.
Dyslipidemia is a frequent side effect associated with nilotinib treatment. Patients with chronic myeloid leukemia (CML) under treatment with nilotinib who develop dyslipidemia have been shown to have a higher risk of presenting atherosclerotic cardiovascular disease (ACVD). Therapeutic discontinuation in selected individuals could be a strategy in order to prevent the development of ACVD. Observational study of patients with CML under nilotinib treatment. The lipid values were gathered before starting with nilotinib and after 3 months. Such values were also measured before discontinuation in patients who suspended nilotinib treatment, as well as 3 and 12 months later. 32 patients were included, 19 of them treated in monotherapy with nilotinib. The concentrations of total cholesterol and low-density lipoproteins (LDL) increased significantly after 3 months of treatment (27.29 mg/dL ± 22.88, p < 0.01). Of the total number of patients treated, 12 discontinued the treatment. LDL concentration was significantly reduced after 3 months of the nilotinib discontinuation (- 27.58 mg/dL ± 38.30, p = 0.030), remaining substantially lower after 12 months, compared to the time previous to discontinuation (- 24.58 mg/dL ± 37.31, p = 0.043). Nilotinib suspension reduces significantly LDL concentrations. These data support the strategy of therapeutic discontinuation in order to prevent future cardiovascular complications, especially in patients with prior cardiovascular risk factors.
脂质代谢异常是尼洛替尼治疗相关的常见副作用。接受尼洛替尼治疗的慢性髓性白血病（CML）患者发生脂质代谢异常时，发生动脉粥样硬化性心血管疾病（ACVD）的风险更高。在选定的个体中停止治疗可能是预防 ACVD 发展的一种策略。对接受尼洛替尼治疗的 CML 患者进行观察性研究。在开始使用尼洛替尼之前和 3 个月后收集血脂值。在停止尼洛替尼治疗的患者中，也在停药前、停药后 3 个月和 12 个月测量这些值。共纳入 32 例患者，其中 19 例接受尼洛替尼单药治疗。治疗 3 个月后，总胆固醇和低密度脂蛋白（LDL）浓度显著升高（27.29mg/dL±22.88，p<0.01）。在接受治疗的患者中，有 12 例停止了治疗。尼洛替尼停药后 3 个月，LDL 浓度显著降低（-27.58mg/dL±38.30，p=0.030），与停药前相比，12 个月时仍明显降低（-24.58mg/dL±37.31，p=0.043）。尼洛替尼停药可显著降低 LDL 浓度。这些数据支持停止治疗的策略，以预防未来的心血管并发症，特别是在有心血管危险因素的患者中。
