Department of Radiation Oncology, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, Guangdong, China.
Ann Hematol. 2024 Aug;103(8):3207-3217. doi: 10.1007/s00277-024-05691-2. Epub 2024 Mar 8.
Histone deacetylase (HDAC) inhibitors are emerging as promising treatments for hematological malignancies, with potential applications extending to solid tumors in the future. Given their wide-ranging biological effects, there is a pressing need for a thorough understanding of the toxicities linked to HDAC inhibition. In this study, a pharmacovigilance analysis was conducted using the FDA Adverse Event Reporting System database. Suspected adverse events linked to HDAC inhibitors were detected through various statistical methodologies, including reporting odds ratio, proportional reporting ratio, information component, and Empirical Bayes Geometric Mean. Our study findings have illuminated that, among the total reported cases examined, gastrointestinal disorders accounted for 13% patients of the cohort, while lymphatic system disorders comprised 8% cases of the cohort, all of which manifested as adverse events induced by HDAC inhibitors. Importantly, the usage of HDAC inhibitors was found to be associated with incidents of atrial fibrillation, heart failure, respiratory failure, hepatic dysfunction, and acute kidney injury. Romidepsin and belinostat demonstrated more pronounced signals of adverse events compared to panobinostat and vorinostat, emphasizing the need for vigilant monitoring of adverse events in this particular population. Furthermore, atrial fibrillation (clinical priority score of 7 points) emerged as the paramount medical event warranting utmost clinical attention. Eventually, multiple adverse events were observe to emerge within the initial and second months following the initiation of treatment. Vigilant monitoring and supportive care strategies are critical in addressing the toxicities associated with HDAC inhibitors, particularly those concerning cardiotoxicity, respiratory toxicity, renal toxicity, and hepatotoxicity.
组蛋白去乙酰化酶(HDAC)抑制剂作为血液系统恶性肿瘤的有前途的治疗方法正在出现,未来可能应用于实体瘤。鉴于它们广泛的生物学效应,迫切需要彻底了解与 HDAC 抑制相关的毒性。在这项研究中,使用 FDA 不良事件报告系统数据库进行了药物警戒分析。通过各种统计方法,包括报告比值比、比例报告比、信息成分和经验贝叶斯几何均数,检测与 HDAC 抑制剂相关的可疑不良事件。我们的研究结果表明,在所检查的总报告病例中,胃肠道疾病占队列患者的 13%,而淋巴系统疾病占队列的 8%,所有这些疾病均表现为 HDAC 抑制剂引起的不良事件。重要的是,HDAC 抑制剂的使用与心房颤动、心力衰竭、呼吸衰竭、肝功能障碍和急性肾损伤的发生有关。罗米地辛和贝林司他与 panobinostat 和 vorinostat 相比,显示出更明显的不良事件信号,这强调了在特定人群中需要对不良事件进行警惕监测。此外,心房颤动(临床优先级评分 7 分)是需要引起高度临床关注的主要医疗事件。最终,在开始治疗后的最初和第二个月内观察到多种不良事件。警惕监测和支持性护理策略对于处理与 HDAC 抑制剂相关的毒性至关重要,特别是那些与心脏毒性、呼吸毒性、肾毒性和肝毒性有关的毒性。