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A real or apparent decrease in glomerular filtration rate in patients using olaparib?
M A C Bruin1, C M Korse2, B van Wijnen2
1Department of Pharmacy & Pharmacology, The Netherlands Cancer Institute - Antoni van Leeuwenhoek, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands. ma.bruin@nki.nl.
European Journal of Clinical Pharmacology
|December 15, 2020
Summary
Olaparib increases creatinine levels by inhibiting renal transporters, not by reducing kidney function. Cystatin C is a more accurate marker for estimating glomerular filtration rate (GFR) in patients taking olaparib.
Area of Science:
- Oncology
- Nephrology
- Pharmacology
Background:
- Olaparib, a PARP inhibitor, is used for ovarian and metastatic breast cancer.
- Elevated serum creatinine in olaparib users suggests potential kidney effects, but the mechanism is unclear.
Purpose of the Study:
- To determine if olaparib treatment increases creatinine levels.
- To assess if observed creatinine increases correlate with reduced glomerular filtration rate (GFR).
Main Methods:
- Retrospective analysis of 66 patients treated with olaparib.
- Measured serum creatinine and cystatin C levels at baseline and during treatment.
- Calculated estimated GFR (eGFR) using both creatinine and cystatin C based equations.
Main Results:
- Olaparib treatment increased median creatinine by 14% and decreased creatinine-based eGFR by 13%.
- No significant changes were observed in median cystatin C levels or cystatin C-based eGFR.
- This indicates olaparib affects creatinine levels independently of GFR.
Conclusions:
- Olaparib likely inhibits renal transporters, causing a reversible increase in creatinine.
- Creatinine-based eGFR may underestimate true GFR in olaparib patients.
- Cystatin C is recommended for accurate eGFR assessment in patients receiving olaparib.
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