阿那莫林治疗癌症恶病质的真实世界安全性和有效性:日本上市后监测的中期分析。

Real-world safety and effectiveness of anamorelin for cancer cachexia: Interim analysis of post-marketing surveillance in Japan.

机构信息

Department of Pulmonary Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan.

Pharmacovigilance, Ono Pharmaceutical Co., Ltd., Osaka, Japan.

出版信息

Cancer Med. 2024 May;13(9):e7170. doi: 10.1002/cam4.7170.

Abstract

BACKGROUND

Anamorelin was approved in Japan in 2021 to treat cancer cachexia associated with non-small cell lung, gastric, pancreatic, or colorectal cancers. Post-marketing surveillance is being conducted to evaluate the real-world safety and effectiveness of anamorelin.

METHODS

This prospective, observational surveillance registered all patients who started treatment with anamorelin after April 21, 2021. Hyperglycemia, hepatic impairment, conduction disorders, and their associated adverse events related to treatment were defined as main safety specifications. Body weight (BW) and appetite were assessed as effectiveness specifications.

RESULTS

This analysis was based on data as of January 21, 2023. The safety and effectiveness analysis sets included 6016 and 4511 patients, respectively. Treatment-related adverse events in ≥1% of patients were hyperglycemia (3.9%) and nausea (2.6%). The incidences of hyperglycemia, hepatic impairment, conduction disorders, and their associated adverse events related to treatment were 4.8%, 1.2%, and 1.1%, respectively. The mean changes (standard error [SE]) in BW from baseline to weeks 3, 12, 24, and 52 were 0.64 (0.05) kg, 1.19 (0.12) kg, 1.40 (0.21) kg, and 1.42 (0.39) kg, respectively. The mean changes (SE) in Functional Assessment of Anorexia/Cachexia Treatment 5-item Anorexia Symptom Scale total scores from baseline to weeks 3, 12, 24, and 52 were 3.2 (0.09), 4.8 (0.18), 5.2 (0.30), and 5.3 (0.47), respectively, exceeding the clinically meaningful improvement score (2.0 points).

CONCLUSION

The overall safety of anamorelin raised no new safety concerns, although continued caution may be required for hyperglycemia and nausea. Improvements in BW and appetite were also observed in real-world clinical settings.

摘要

背景

盐酸恩那司他林于 2021 年在日本获批,用于治疗非小细胞肺癌、胃癌、胰腺癌或结直肠癌相关的癌性恶病质。正在进行上市后监测,以评估盐酸恩那司他林的真实世界安全性和有效性。

方法

这是一项前瞻性观察性监测,登记了所有自 2021 年 4 月 21 日后开始接受盐酸恩那司他林治疗的患者。高血糖、肝损伤、传导障碍及其与治疗相关的不良事件被定义为主要安全性指标。体重(BW)和食欲被评估为有效性指标。

结果

本分析基于截至 2023 年 1 月 21 日的数据。安全性和有效性分析集分别纳入 6016 例和 4511 例患者。≥1%的患者出现治疗相关不良事件为高血糖(3.9%)和恶心(2.6%)。高血糖、肝损伤、传导障碍及其与治疗相关的不良事件的发生率分别为 4.8%、1.2%和 1.1%。从基线到第 3、12、24 和 52 周时 BW 的平均变化(标准误差[SE])分别为 0.64(0.05)kg、1.19(0.12)kg、1.40(0.21)kg 和 1.42(0.39)kg。从基线到第 3、12、24 和 52 周时,功能性评估厌食/恶病质治疗 5 项厌食症状量表总评分的平均变化(SE)分别为 3.2(0.09)、4.8(0.18)、5.2(0.30)和 5.3(0.47),均超过临床有意义的改善评分(2.0 分)。

结论

盐酸恩那司他林的总体安全性未产生新的安全性担忧,尽管仍需对高血糖和恶心保持谨慎。在真实世界的临床环境中也观察到了 BW 和食欲的改善。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ac30/11063721/a41e4b1a21c9/CAM4-13-e7170-g003.jpg

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