Risk of hypertension associated with vascular endothelial growth factor receptor tyrosine kinase inhibitors in patients with non-small cell lung cancer:a Meta-analysis
10.3760/cma.j.issn.1008-5734.2018.01.006
- VernacularTitle:血管内皮生长因子受体酪氨酸激酶抑制剂致非小细胞肺癌患者高血压风险Meta分析
- Author:
Anhua WEI
1
;
Yufeng DING
;
Jinlan PENG
Author Information
1. 华中科技大学同济医学院附属同济医院药学部, 武汉,430030
- Publication Type:Journal Article
- Keywords:
Vascular endothelial growth factor;
Carcinoma,non-small-cell lung;
Hypertension;
Meta-analysis
- From:
Adverse Drug Reactions Journal
2018;20(1):30-37
- CountryChina
- Language:Chinese
-
Abstract:
Objective To systematically evaluate the risk of hypertension and serious hypertension due to vascular endothelial growth factor receptor tyrosine kinase inhibitors(VEGFR-TKIs)in patients with non-small cell lung cancer(NSCLC). Methods The related databases were searched for the randomized controlled trials(RCTs)on the hypertension induced by VEGFR-TKI before August 2017. The patients with NSCLC who were treated with VEGFR-TKIs were enrolled into the test group,the patients who received placebo and/or the patients in the test group who used the other drugs except VEGFR-TKI were enrolled into the control group. The outcomes of all RCTs were the incidence of hypertension and serious hypertension. The quality of the enrolled literature was evaluated by Jadad scoring system. The Meta-analysis was conducted by STATA 13.1 software. The results were expressed as relative risk(RR)and 95% confidence interval(CI). Results A total of 18 RCTs involving 10 020 patient were enrolled,including 5 274 in the test group and 4 746 in the control group. The result of literature′s quality evaluation showed 13 of high grade and 5 of low grade. The results of the Meta-analysis showed that the incidence of a hypertension and serious hypertension in test group were significantly higher than those in the control group,respectively [15.8%(834/5 274)vs. 3.8%(179/4 746),RR=4.11,95%CI:3.50-4.81,P<0.001;3.49%(184/5 274)vs. 0.70%(33/4 746),RR=4.64,95%CI:3.22-6.68,P<0.001]. The results of the subgroup analysis showed that the incidences of hypertension and serious hypertension in the vandetanib group were significantly higher than those in the control group[15.1%(397/2 625)vs. 2.3%(49/2 136),RR=3.72,95%CI:2.80-4.95,P<0.001;3.4%(90/2 625)vs. 0.6%(13/2 163),RR=5.99,95%CI:4.45-8.07,P <0.001];the incidences of hypertension and serious hypertension in the sorafenib group were significantly higher than those in the control group[15.7%(201/1 278)vs. 5.4%(68/1 249),RR=2.90,95%CI:2.22-3.79,P<0.001;4.0%(52/1 278)vs. 1.0%(12/1 249), RR=4.09,95%CI:2.21-7.55,P<0.001];the incidences of hypertension and serious hypertension in the cediranib group were significantly higher than those in the control group[32.1%(89/277)vs. 8.7%(24/276),RR=3.70,95%CI:2.43-5.62,P<0.001;12.2%(34/277)vs. 1.8%(5/276),RR=6.77,95%CI:2.68-17.08,P<0.001];and the incidence of hypertension in the motesanib group was significantly higher than that in the control group[26.1%(139/533)vs. 6.5%(35/539),RR=4.02, 95%CI:2.83-5.70,P<0.001]. Conclusion The risk of hypertension and serious hypertension may increase in the NSCLC patients who received VEGFR-TKIs.
