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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.

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Haguet, Hélène Douxfils, Jonathan Mullier, François [UCL] Chatelain, Christian [UCL] Graux, Carlos [UCL] Dogné, Jean-Michel

(eng) 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.

Document type Article de périodique (Journal article) – Article de recherche
Access type Accès restreint
Publication date 2017
Language Anglais
Journal information "Expert Opinion on Drug Safety" - Vol. 16, no. 1, p. 5-12 (2017)
Peer reviewed yes
Publisher Informa Healthcare ((United Kingdom) London)
issn 1474-0338
e-issn 1744-764X
Publication status Publié
Affiliations UCL - (MGD) Laboratoire de biologie clinique
UCL - (MGD) Service d'hématologie
UCL - SSS/IREC/MONT - Pôle Mont Godinne
UCL - SSS/IREC/MIRO - Pôle d'imagerie moléculaire, radiothérapie et oncologie
Keywords Arterial occlusive disease ; BCR-ABL positive ; chronic ; Leukemia ; Meta-analysis ; Myelogenous ; Protein kinase inhibitors ; Venous thrombosis
Links
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Bibliographic reference Haguet, Hélène ; Douxfils, Jonathan ; Mullier, François ; Chatelain, Christian ; Graux, Carlos ; et. al. 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.. In: Expert Opinion on Drug Safety, Vol. 16, no. 1, p. 5-12 (2017)
Permanent URL http://hdl.handle.net/2078.1/178055