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Analyses of Proteinuria, Renal Infiltration of Leukocytes, and Renal Deposition of Proteins in Lupus-prone MRL/lpr Mice
Published on: June 8, 2022
Management of lenvatinib-induced proteinuria with dapagliflozin
J Matías Calabretta1, M Laura Iglesias1, Agostina Paggetta1
1División Endocrinología, Instituto de Oncología Ángel H. Roffo, Universidad de Buenos Aires, Buenos Aires, Argentina.
Abstract:
Proteinuria is an adverse event described in 30% of thyroid cancer patients treated with lenvatinib, a tyrosine kinase inhibitor targeting vascular endothelial growth factor receptors. Management of proteinuria is challenging, involving control of arterial hypertension. We describe the case of a patient with advanced radioiodine refractory thyroid cancer treated with lenvatinib who developed late-onset grade 3 proteinuria, despite adequate blood pressure control. He was treated with dapagliflozin 10 mg/day, which promptly improved proteinuria to grade 1. Treatment with lenvatinib was subsequently restarted, with good control of proteinuria. Dapagliflozin is a sodiumglucose co-transporter type 2 (SGLT2) inhibitor that acts in the proximal convoluted tubule, improving renal function in diabetic and non-diabetic patients. SGLT2 inhibitors may have a role in the management of lenvatinib-induced proteinuria, however further study is needed.
Insights
Dapagliflozin, a sodium-glucose co-transporter type 2 inhibitor, effectively managed severe proteinuria in a thyroid cancer patient receiving lenvatinib. This suggests SGLT2 inhibitors may help control this common adverse event.
Area of Science:
- Oncology
- Nephrology
- Pharmacology
Background:
- Proteinuria is a common adverse event (30%) in thyroid cancer patients treated with lenvatinib, a tyrosine kinase inhibitor targeting VEGF receptors.
- Management of lenvatinib-induced proteinuria is challenging, often requiring arterial hypertension control.
- Late-onset, grade 3 proteinuria developed in a patient with advanced radioiodine-refractory thyroid cancer despite adequate blood pressure control.
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