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肾细胞癌患者中酪氨酸激酶抑制剂所致高血压的发病率、现状及相关因素

Incidence Status and Factors Associated With Tyrosine Kinase Inhibitor-Induced Hypertension in Patients With Renal Cell Carcinoma.

作者信息

Nakanishi Satoru, Ikegami Keisuke, Imai Shungo, Kizaki Hayato, Hori Satoko

机构信息

Division of Drug Informatics, Keio University Faculty of Pharmacy, Tokyo, Japan.

出版信息

Cancer Rep (Hoboken). 2025 May;8(5):e70219. doi: 10.1002/cnr2.70219.

Abstract

BACKGROUND

Although hypertension is a common side effect of tyrosine kinase inhibitor (TKI) treatment for renal cell carcinoma (RCC), there is limited evidence regarding its occurrence and related risk factors. Preliminary studies suggest that proton pump inhibitors (PPIs) may mitigate the risk of TKI-induced hypertension; however, their clinical effectiveness remains unclear.

AIMS

In this study, we examined the prevalence of TKI-induced hypertension and the patterns of antihypertensive prescriptions among patients with RCC in Japan. Additionally, we investigated factors associated with TKI-induced hypertension to assess the potential impact of PPIs.

METHODS AND RESULTS

Data from patients diagnosed with RCC who were prescribed TKIs between April 2008 and July 2021 were retrospectively gathered from a Japanese administrative database. TKI-induced hypertension was detected following the diagnosis of hypertension and subsequently the prescription of an antihypertensive agent during TKI therapy. The prescription details for antihypertensive agents were organized in a tabular format. Cox proportional hazards regression analysis was conducted to examine factors contributing to TKI-induced hypertension. Among the 225 patients analyzed, 36.4% experienced hypertension, and calcium channel blockers were the most prescribed antihypertensive agents. Pre-existing hypertension was identified as a risk factor for TKI-induced hypertension, while the concurrent use of PPIs did not show a tendency to reduce the risk of TKI-induced hypertension.

CONCLUSIONS

These findings indicate the importance of blood pressure management in patients with elevated baseline blood pressure.

摘要

背景

尽管高血压是酪氨酸激酶抑制剂(TKI)治疗肾细胞癌(RCC)的常见副作用,但关于其发生情况及相关危险因素的证据有限。初步研究表明,质子泵抑制剂(PPI)可能会降低TKI诱导的高血压风险;然而,其临床疗效仍不明确。

目的

在本研究中,我们调查了日本RCC患者中TKI诱导的高血压患病率以及抗高血压药物的处方模式。此外,我们研究了与TKI诱导的高血压相关的因素,以评估PPI的潜在影响。

方法与结果

从日本一个行政数据库中回顾性收集了2008年4月至2021年7月期间被诊断为RCC并开具TKI处方的患者的数据。在诊断为高血压并随后在TKI治疗期间开具抗高血压药物后,检测到TKI诱导的高血压。抗高血压药物的处方细节以表格形式整理。进行Cox比例风险回归分析以检查导致TKI诱导的高血压的因素。在分析的225例患者中,36.4%出现高血压,钙通道阻滞剂是最常开具的抗高血压药物。既往高血压被确定为TKI诱导的高血压的一个危险因素,而同时使用PPI并未显示出降低TKI诱导的高血压风险的趋势。

结论

这些发现表明了对基线血压升高的患者进行血压管理的重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8a5c/12046976/e850ebf35631/CNR2-8-e70219-g003.jpg

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