多发性骨髓瘤治疗选择中心脏毒性结局的风险平衡：伊沙佐米、来那度胺和地塞米松（IRd）对比卡非佐米、来那度胺和地塞米松（KRd）的回顾性多中心评估
Balancing the Risk of Cardiotoxicity Outcomes in Treatment Selection for Multiple Myeloma: A Retrospective Multicenter Evaluation of Ixazomib, Lenalidomide, and Dexamethasone (IRd) Versus Carfilzomib, Lenalidomide, and Dexamethasone (KRd).
作者信息
Lee Benjamin J, Sayer Michael, Naqvi Ali A, Mai Karen T, Patel Pranav M, Lee Lisa X, Ozaki Aya F
机构信息
Department of Pharmacy Chao Family Comprehensive Cancer Center University of California Irvine Health Orange California USA.
Department of Clinical Pharmacy Practice School of Pharmacy & Pharmaceutical Sciences University of California Irvine California USA.
出版信息
EJHaem. 2025 Apr 28;6(3):e70038. doi: 10.1002/jha2.70038. eCollection 2025 Jun.
INTRODUCTION
Carfilzomib use has been extensively associated with cardiovascular toxicity; the risk with ixazomib, a novel oral proteasome inhibitor, is underreported and no large comparative analysis is available.
METHODS
We conducted a retrospective cohort study utilizing the TriNetX platform to compare toxicity outcomes among multiple myeloma patients who received lenalidomide, dexamethasone, and ixazomib (IRd) or carfilzomib (KRd).
RESULTS
After propensity-score-matching 478 patients from each cohort, the onset of new heart failure (HR 0.25; < 0.001) and arrhythmias (HR 0.57; = 0.014) at 6 months were significantly lower with IRd while overall survival at 3 years was similar ( = 0.50).
CONCLUSION
IRd is associated with a significantly lower risk of cardiac toxicities compared to KRd.
引言
卡非佐米的使用与心血管毒性广泛相关；新型口服蛋白酶体抑制剂伊沙佐米的相关风险报道较少，且尚无大型对比分析。
方法
我们利用TriNetX平台进行了一项回顾性队列研究，以比较接受来那度胺、地塞米松和伊沙佐米（IRd）或卡非佐米（KRd）的多发性骨髓瘤患者的毒性结果。
结果
在对每个队列中的478例患者进行倾向评分匹配后，IRd组在6个月时新发心力衰竭（HR 0.25；<0.001）和心律失常（HR 0.57；=0.014）的发生率显著较低，而3年总生存率相似（=0.50）。
结论
与KRd相比，IRd发生心脏毒性的风险显著更低。
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