Abstract

Prolonged survival and expanded treatment options in myeloma patients have led to adverse events associated with treatment getting increased attention. This systematic review and meta-analysis aimed to determine the incidence of ixazomib–associated cardiovascular adverse events (CVAEs) and to compare the rates of ixazomib–associated CVAEs and related therapies. CVAEs were defined as heart failure, hypertension, ischemia, and arrhythmia. All-grade and high-grade CVAEs and study characteristics were recorded. A total of 266 potentially relevant articles were identified, and 246 were excluded after review. Twenty studies of 1715 patients with multiple myeloma were thus considered in this study. The estimated rates of all-grade and high-grade ixazomib associated CVAEs were 11.2 and 3.7%, respectively. Subgroup analysis showed that median age ≥65 years, none phase 1 trial and combination regimen were associated with higher rates of high-grade ixazomib associated CVAEs. Ixazomib was association with increased high-grade CVAEs risk (RR = 1.679, 95% CI: 1.078–2.615, P = 0.022). Ixazomib was associated with a significant rate of high-grade CVAEs. Future studies are needed to identify patients at high risk for high-grade CVAEs.

摘要

骨髓瘤患者的延长生存期和扩大的治疗选择导致与治疗相关的不良事件越来越受到关注。该系统评价和荟萃分析旨在确定 ixazomib 相关心血管不良事件 (CVAE) 的发生率，并比较 ixazomib 相关 CVAE 和相关疗法的发生率。CVAE 被定义为心力衰竭、高血压、缺血和心律失常。记录了所有级别和高级别的 CVAE 和研究特征。共识别出266篇可能相关的文章，246篇经审查排除。因此，本研究考虑了对 1715 名多发性骨髓瘤患者的 20 项研究。全级别和高级别 ixazomib 相关 CVAE 的估计发生率分别为 11.2% 和 3.7%。亚组分析显示中位年龄≥65 岁，没有一项 1 期试验和联合方案与较高的高级别 ixazomib 相关 CVAE 发生率相关。Ixazomib 与高级别 CVAE 风险增加相关（RR = 1.679, 95% CI: 1.078–2.615,P  = 0.022）。Ixazomib 与高级别 CVAE 发生率显着相关。需要未来的研究来识别高级别 CVAE 的高风险患者。