Risk of Immunomodulatory Drugs in the Treatment of Deep Venous Thrombosis in Multiple Myeloma ：Systematic Evaluation and Meta-analysis
- VernacularTitle:免疫调节药物治疗多发性骨髓瘤发生深静脉血栓风险的系统评价和Meta分析
- Author:
Guihang DENG
1
;
Min CHEN
2
;
Haili ZHONG
3
;
Jianchao ZHANG
4
Author Information
1. Dept. of Pharmacy，Dongguan Maternal & Child Health Hospital，Guangdong Dongguan 523000，China
2. Dept. of Pharmacy，Jingzhou First People’s Hospital，Hubei Jingzhou 434000，China
3. Dept. of Pharmacy，the First Affiliated Hospital of Nanchang University，Nanchang 330006，China
4. Dept. of Medicine，Shenzhen University，Guangdong Shenzhen 518060，China
- Publication Type:Journal Article
- Keywords:
Immunomodulatory drug;
Multiple myeloma;
Deep venous thrombosis;
Systematic review;
Meta-analysis
- From:
China Pharmacy
2019;30(19):2701-2706
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVE： To evaluate immunomodulatory drugs （IMiDs） in the treatment of deep venous thrombosis （DVT） in patients with multiple myeloma （MM） systematically， and to provide reference for safe drug use in clinic. METHODS： Retrieved and collected randomized controlled trials （RCTs） about the risk of DVT in MM patients treated with IMiDs from PubMed， Web of Science， Cochrane library， CJFD， Wanfang database， VIP， www.ClinicalTrials.gov during database and Dec. 31， 2018. Meta-analysis was conducted for the incidence and relative risk of DVT （RR） by using Stata 12.0 statistical software. Evidence was evaluated and graded by using GRADE system. RESULTS： A total of 11 RCTs were included， involving 3 365 patients （including 3 drugs）. Results of Meta-analysis showed that the incidence of DVT was 7.3％ [95％CI （4.5％， 10.2％）] during IMiDs in the treatment of MM. Compared with conventional chemotherapy， IMiDs had a higher risk of DVT in MM patients [RR＝3.57，95％CI（2.42，5.27）， P＜0.01]. Subgroup analysis in different treatment stage showed that after IMiDs treatment for MM patients at induction stage， the risk of DVT increased by 386％ compared with conventional chemotherapy plan [RR＝4.86， 95％CI （2.85， 8.30）， P＜0.01]， which evidence was moderate. Compared with conventional chemotherapy plan， there was no significant difference in the risk of DVT among MM patients treated with IMiDs at maintenance stage [RR＝2.40， 95％CI （0.70， 8.27）， P＝0.16] and relapse stage [RR＝2.01， 95％CI （0.74， 5.46）， P＝0.17]. The incidence of severe DVT caused by thalidomide and lenalidomide were 11％ [95％CI （9％， 13％）] and 3％ [95％CI （2％， 4％）]. CONCLUSIONS： The current evidence suggests that patients with MM treated with IMiDs are at a high risk of serious DVT， and clinical medication should be cautious.
