Risk of arterial and venous occlusive events in chronic myeloid leukemia patients treated with new generation BCR-ABL tyrosine kinase inhibitors: a systematic review and meta-analysis

Résultats de recherche: Contribution à un journal/une revueArticle

Résumé

Background: A previous meta-analysis demonstrated that 3 of the new-generation BCR-ABL tyrosine kinase inhibitors (TKIs) (dasatinib, nilotinib and ponatinib) are associated with an increased risk of vascular occlusive events in patients with Ph+ chronic myeloid leukemia compared with imatinib. This meta-analysis of randomized controlled trials aims at assessing these risks separately. Methods: The literature search was performed by two independent reviewers following the previous protocol (PROSPERO 2014:CRD42014014147). A random-effects model and a fixed-effect model were used according to the characteristics of the included studies. Peto odds ratios with 95%CI were computed. Results: Overall, 4.78% of patients developed arterial occlusive events with new generation TKIs compared with 0.96% with imatinib. Ponatinib (ORPETO:3.26; 95%CI:1.12 to 9.50), nilotinib (ORPETO: 3.69; 95%CI:2.29 to 5.95) and dasatinib (ORPETO:3.32; 95%CI:1.37 to 8.01) are all associated with a higher risk of arterial occlusive events than imatinib. Venous occlusive events occur in 0.72% of patients treated with new generation TKIs and in 0.27% of imatinib-treated patients. Overall, a trend toward an increase of the rate of venous occlusive events with new-generation TKIs (ORPETO:2.17; 95%CI:0.90 to 5.25) was highlighted but stratifications by treatment gave nonsignificant results. Conclusions: Vascular occlusive events associated with new-generation BCR-ABL TKIs are driven by arterial occlusive events.

langue originaleAnglais
Pages (de - à)1-8
Nombre de pages8
journalExpert Opinion On Drug Safety
Les DOIs
étatPublié - 2016

Empreinte digitale

Leukemia, Myelogenous, Chronic, BCR-ABL Positive
Protein-Tyrosine Kinases
Meta-Analysis
Blood Vessels
Randomized Controlled Trials
Odds Ratio
Imatinib Mesylate
4-methyl-N-(3-(4-methylimidazol-1-yl)-5-(trifluoromethyl)phenyl)-3-((4-pyridin-3-ylpyrimidin-2-yl)amino)benzamide
Dasatinib
ponatinib
Therapeutics

Citer ceci

@article{8eec6f55599847fc8c4f4315092eed82,
title = "Risk of arterial and venous occlusive events in chronic myeloid leukemia patients treated with new generation BCR-ABL tyrosine kinase inhibitors: a systematic review and meta-analysis",
abstract = "Background: A previous meta-analysis demonstrated that 3 of the new-generation BCR-ABL tyrosine kinase inhibitors (TKIs) (dasatinib, nilotinib and ponatinib) are associated with an increased risk of vascular occlusive events in patients with Ph+ chronic myeloid leukemia compared with imatinib. This meta-analysis of randomized controlled trials aims at assessing these risks separately. Methods: The literature search was performed by two independent reviewers following the previous protocol (PROSPERO 2014:CRD42014014147). A random-effects model and a fixed-effect model were used according to the characteristics of the included studies. Peto odds ratios with 95{\%}CI were computed. Results: Overall, 4.78{\%} of patients developed arterial occlusive events with new generation TKIs compared with 0.96{\%} with imatinib. Ponatinib (ORPETO:3.26; 95{\%}CI:1.12 to 9.50), nilotinib (ORPETO: 3.69; 95{\%}CI:2.29 to 5.95) and dasatinib (ORPETO:3.32; 95{\%}CI:1.37 to 8.01) are all associated with a higher risk of arterial occlusive events than imatinib. Venous occlusive events occur in 0.72{\%} of patients treated with new generation TKIs and in 0.27{\%} of imatinib-treated patients. Overall, a trend toward an increase of the rate of venous occlusive events with new-generation TKIs (ORPETO:2.17; 95{\%}CI:0.90 to 5.25) was highlighted but stratifications by treatment gave nonsignificant results. Conclusions: Vascular occlusive events associated with new-generation BCR-ABL TKIs are driven by arterial occlusive events.",
keywords = "Arterial occlusive disease, BCR-ABL positive, chronic, leukemia, meta-analysis, myelogenous, protein kinase inhibitors, venous thrombosis",
author = "H{\'e}l{\`e}ne Haguet and Jonathan Douxfils and Fran{\cc}ois Mullier and Christian Chatelain and Carlos Graux and Dogn{\'e}, {Jean Michel}",
year = "2016",
doi = "10.1080/14740338.2017.1261824",
language = "English",
pages = "1--8",
journal = "Expert Opinion On Drug Safety",
issn = "1474-0338",
publisher = "Informa Healthcare",

}

TY - JOUR

T1 - Risk of arterial and venous occlusive events in chronic myeloid leukemia patients treated with new generation BCR-ABL tyrosine kinase inhibitors

T2 - a systematic review and meta-analysis

AU - Haguet, Hélène

AU - Douxfils, Jonathan

AU - Mullier, François

AU - Chatelain, Christian

AU - Graux, Carlos

AU - Dogné, Jean Michel

PY - 2016

Y1 - 2016

N2 - Background: A previous meta-analysis demonstrated that 3 of the new-generation BCR-ABL tyrosine kinase inhibitors (TKIs) (dasatinib, nilotinib and ponatinib) are associated with an increased risk of vascular occlusive events in patients with Ph+ chronic myeloid leukemia compared with imatinib. This meta-analysis of randomized controlled trials aims at assessing these risks separately. Methods: The literature search was performed by two independent reviewers following the previous protocol (PROSPERO 2014:CRD42014014147). A random-effects model and a fixed-effect model were used according to the characteristics of the included studies. Peto odds ratios with 95%CI were computed. Results: Overall, 4.78% of patients developed arterial occlusive events with new generation TKIs compared with 0.96% with imatinib. Ponatinib (ORPETO:3.26; 95%CI:1.12 to 9.50), nilotinib (ORPETO: 3.69; 95%CI:2.29 to 5.95) and dasatinib (ORPETO:3.32; 95%CI:1.37 to 8.01) are all associated with a higher risk of arterial occlusive events than imatinib. Venous occlusive events occur in 0.72% of patients treated with new generation TKIs and in 0.27% of imatinib-treated patients. Overall, a trend toward an increase of the rate of venous occlusive events with new-generation TKIs (ORPETO:2.17; 95%CI:0.90 to 5.25) was highlighted but stratifications by treatment gave nonsignificant results. Conclusions: Vascular occlusive events associated with new-generation BCR-ABL TKIs are driven by arterial occlusive events.

AB - Background: A previous meta-analysis demonstrated that 3 of the new-generation BCR-ABL tyrosine kinase inhibitors (TKIs) (dasatinib, nilotinib and ponatinib) are associated with an increased risk of vascular occlusive events in patients with Ph+ chronic myeloid leukemia compared with imatinib. This meta-analysis of randomized controlled trials aims at assessing these risks separately. Methods: The literature search was performed by two independent reviewers following the previous protocol (PROSPERO 2014:CRD42014014147). A random-effects model and a fixed-effect model were used according to the characteristics of the included studies. Peto odds ratios with 95%CI were computed. Results: Overall, 4.78% of patients developed arterial occlusive events with new generation TKIs compared with 0.96% with imatinib. Ponatinib (ORPETO:3.26; 95%CI:1.12 to 9.50), nilotinib (ORPETO: 3.69; 95%CI:2.29 to 5.95) and dasatinib (ORPETO:3.32; 95%CI:1.37 to 8.01) are all associated with a higher risk of arterial occlusive events than imatinib. Venous occlusive events occur in 0.72% of patients treated with new generation TKIs and in 0.27% of imatinib-treated patients. Overall, a trend toward an increase of the rate of venous occlusive events with new-generation TKIs (ORPETO:2.17; 95%CI:0.90 to 5.25) was highlighted but stratifications by treatment gave nonsignificant results. Conclusions: Vascular occlusive events associated with new-generation BCR-ABL TKIs are driven by arterial occlusive events.

KW - Arterial occlusive disease

KW - BCR-ABL positive

KW - chronic

KW - leukemia

KW - meta-analysis

KW - myelogenous

KW - protein kinase inhibitors

KW - venous thrombosis

UR - http://www.scopus.com/inward/record.url?scp=84999663814&partnerID=8YFLogxK

U2 - 10.1080/14740338.2017.1261824

DO - 10.1080/14740338.2017.1261824

M3 - Article

C2 - 27852118

SP - 1

EP - 8

JO - Expert Opinion On Drug Safety

JF - Expert Opinion On Drug Safety

SN - 1474-0338

ER -