Cardiovascular events associated with use of tyrosine kinase inhibitors in chronic myeloid leukemia
(2016) In Annals of Internal Medicine 165(3). p.161-166- Abstract
Background: Tyrosine kinase inhibitors (TKIs) have increased survival dramatically for patients with chronic myeloid leukemia (CML), but continuous administration of these drugs may elicit long-term toxicity. Objective: To investigate the incidence of vascular events in patients with CML treated with first-and second-generation TKIs. Design: Retrospective cohort study using nationwide population-based registries. Setting: Sweden. Patients: All patients diagnosed with chronic-phase CML in Sweden from 2002 to 2012 and treated with a TKI, and 5 ageand sex-matched control individuals per patient. Measurements: Relative risks, expressed as incidence rate ratios comparing patients with control individuals, were calculated. Events per 1000... (More)
Background: Tyrosine kinase inhibitors (TKIs) have increased survival dramatically for patients with chronic myeloid leukemia (CML), but continuous administration of these drugs may elicit long-term toxicity. Objective: To investigate the incidence of vascular events in patients with CML treated with first-and second-generation TKIs. Design: Retrospective cohort study using nationwide population-based registries. Setting: Sweden. Patients: All patients diagnosed with chronic-phase CML in Sweden from 2002 to 2012 and treated with a TKI, and 5 ageand sex-matched control individuals per patient. Measurements: Relative risks, expressed as incidence rate ratios comparing patients with control individuals, were calculated. Events per 1000 person-years were assessed in interdrug comparisons. Results: 896 patients, 94.4% with documented TKI treatment, were followed for a median of 4.2 years. There were 54 arterial and 20 venous events in the CML cohort, corresponding to relative risks of 1.5 (95% CI, 1.1 to 2.1) and 2.0 (CI, 1.2 to 3.3), respectively. The event rate for myocardial infarction was higher in patients treated with nilotinib or dasatinib (29 and 19 per 1000 person-years, respectively) than in those receiving imatinib (8 per 1000 person-years), although data are limited and the CIs were wide and overlapped. Among 31 patients treated with a TKI who had myocardial infarction, 26 (84%) had at least 1 major cardiac risk factor diagnosed before the event occurred. Limitations: Patients may have been exposed to multiple TKIs. Data on second-and third-generation TKIs were limited. Conclusion: An increased risk for arterial and venous vascular events was seen in patients with CML treated with a TKI. Further study is needed to determine whether the risk for myocardial infarction increases with second-generation drugs.
(Less)
- author
- organization
- publishing date
- 2016-08-02
- type
- Contribution to journal
- publication status
- published
- subject
- in
- Annals of Internal Medicine
- volume
- 165
- issue
- 3
- pages
- 6 pages
- publisher
- American College of Physicians
- external identifiers
-
- scopus:84980347521
- pmid:27295519
- wos:000380583300004
- ISSN
- 0003-4819
- DOI
- 10.7326/M15-2306
- language
- English
- LU publication?
- yes
- id
- 7eb2cb0a-190e-4eeb-8a0f-4f0018d4ab1c
- date added to LUP
- 2016-08-25 16:17:21
- date last changed
- 2024-06-01 14:47:07
@article{7eb2cb0a-190e-4eeb-8a0f-4f0018d4ab1c,
abstract = {{<p>Background: Tyrosine kinase inhibitors (TKIs) have increased survival dramatically for patients with chronic myeloid leukemia (CML), but continuous administration of these drugs may elicit long-term toxicity. Objective: To investigate the incidence of vascular events in patients with CML treated with first-and second-generation TKIs. Design: Retrospective cohort study using nationwide population-based registries. Setting: Sweden. Patients: All patients diagnosed with chronic-phase CML in Sweden from 2002 to 2012 and treated with a TKI, and 5 ageand sex-matched control individuals per patient. Measurements: Relative risks, expressed as incidence rate ratios comparing patients with control individuals, were calculated. Events per 1000 person-years were assessed in interdrug comparisons. Results: 896 patients, 94.4% with documented TKI treatment, were followed for a median of 4.2 years. There were 54 arterial and 20 venous events in the CML cohort, corresponding to relative risks of 1.5 (95% CI, 1.1 to 2.1) and 2.0 (CI, 1.2 to 3.3), respectively. The event rate for myocardial infarction was higher in patients treated with nilotinib or dasatinib (29 and 19 per 1000 person-years, respectively) than in those receiving imatinib (8 per 1000 person-years), although data are limited and the CIs were wide and overlapped. Among 31 patients treated with a TKI who had myocardial infarction, 26 (84%) had at least 1 major cardiac risk factor diagnosed before the event occurred. Limitations: Patients may have been exposed to multiple TKIs. Data on second-and third-generation TKIs were limited. Conclusion: An increased risk for arterial and venous vascular events was seen in patients with CML treated with a TKI. Further study is needed to determine whether the risk for myocardial infarction increases with second-generation drugs.</p>}},
author = {{Dahlén, Torsten and Edgren, Gustaf and Lambe, Mats and Höglund, Martin and Björkholm, Magnus and Sandin, Fredrik and Själander, Anders and Richter, Johan and Olsson-Strömberg, Ulla and Ohm, Lotta and Bäck, Magnus and Stenke, Leif}},
issn = {{0003-4819}},
language = {{eng}},
month = {{08}},
number = {{3}},
pages = {{161--166}},
publisher = {{American College of Physicians}},
series = {{Annals of Internal Medicine}},
title = {{Cardiovascular events associated with use of tyrosine kinase inhibitors in chronic myeloid leukemia}},
url = {{http://dx.doi.org/10.7326/M15-2306}},
doi = {{10.7326/M15-2306}},
volume = {{165}},
year = {{2016}},
}