与前列腺癌患者的雄激素受体轴向剂相关的心血管毒性:随机对照试验的元分析
Susu Zhou1, Parissa Alerasool2, Noriko Kishi3
1Department of Medicine, Icahn School of Medicine at Mount Sinai, Mount Sinai Beth Israel, New York, NY.
Clinical genitourinary cancer
|April 7, 2024
概括
第二代雄激素受体轴向剂 (ARAT) 在前列腺癌患者中增加心血管风险. 警监测心肌梗塞和胸痛等事件至关重要,特别是对于那些有现有危险因素的人来说.
科学领域:
- 在瘤学瘤学.
- 心脏病学 心脏病学
- 药理学 药理学是指药理学的学科.
背景情况:
- 第二代雄激素受体轴向 (ARAT) 剂是晚期前列腺癌 (PC) 的标准.
- 与ARAT药物相关的潜在心血管毒性仍然在很大程度上没有被描述.
- 了解这些风险对于患者管理至关重要.
研究的目的:
- 在前列腺癌 (PC) 患者中系统评估与ARAT药物相关的心血管不良事件 (CVAE).
- 量化特定心血管事件的风险,包括心肌梗塞和胸痛.
- 为了确定个别ARAT剂之间心血管风险的差异.
主要方法:
- 在主要数据库 (PubMed,Embase,Web of Science,Cochrane) 进行系统的文献搜索,寻找相关的随机对照试验 (RCT),直到2023年3月.
- 在接受ARAT药物治疗和不接受ARAT药物治疗的患者中,对所有等级和高等级CVAE的几率比率 (ORs) 的元分析.
- 根据PC类型和治疗方案进行了子组分析.
主要成果:
- 分析了15个双盲,安慰剂控制的3期试验,涉及15842名患者.
- ARAT药物显著增加了急性心肌梗塞 (OR: 1.96),心肌梗塞 (OR: 2.44) 和胸痛 (OR: 2.00) 的风险.
- 恩扎胺,阿比拉和阿帕胺与急性心肌梗塞,胸痛和心肌梗塞风险增加的特定关联.
结论:
- ARAT剂与几种心血管不良事件 (CVAE) 的风险显著增加有关.
- 临床医生必须在治疗前查和持续监测CVAE时保持警.
- 在处方ARAT药物时,需要特别注意患有先前存在心血管风险因素的患者.
关键词:
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