Welcome to visit Zhongnan Medical Journal Press Series journal website!

Home Articles Vol 32,2023 No.11 Detail

Data mining for hypertension associated with VEGFR-TKIs: based on FAERS database

Published on Nov. 30, 2023Total Views: 1618 times Total Downloads: 529 times Download Mobile

Author: Xiao-Lan LIAO 1 Jia-Qi GE 2 Hai-Bin ZHU 1 Ting-Ting WU 1 Chun-Xia REN 1 Zi-Cheng YU 1

Affiliation: 1. Department of Pharmacy, Yangpu Hospital, Tongji University, Shanghai 200090, China 2. School of Medicine and Pharmacy, Ocean University of China, Qingdao 266003, Shandong Province, China

Keywords: Vascular endothelial growth factor receptor-tyrosine kinase inhibitors Hypertension Adverse drug events Pharmacovigilance FAERS database

DOI: 10.19960/j.issn.1005-0698.202311001

Reference: Xiao-Lan LIAO, Jia-Qi GE, Hai-Bin ZHU, Ting-Ting WU, Chun-Xia REN, Zi-Cheng YU.Data mining for hypertension associated with VEGFR-TKIs: based on FAERS database[J].Yaowu Liuxingbingxue Zazhi,2023, 32(11): 1201-1208.DOI: 10.19960/j.issn.1005-0698.202311001.[Article in Chinese]

  • Abstract
  • Full-text
  • References
Abstract

Objective  To analyze the characteristics of hypertension adverse event (AE) associated with vascular endothelial growth factor receptor (VEGFR) - tyrosine kinase inhibitors (TKIs) and compare the hypertension AE signals and onset time among different VEGFR-TKIs.

Methods  A retrospective analysis of VEGFR-TKIs-associated hypertension AE reports in the U.S. Food and Drug Administration Adverse Event Reporting System (FAERS) database from the first quarter of 2004 to the fourth quarter of 2020 was performed to detect the AE signs of VEGFR-TKIs-associated hypertension by the reporting odds ratio (ROR) method, composite criteria method of Medicines and Healthcare Products Regulatory Agency (MHRA) in the UK and information component (IC) method, and the data were managed and visualized by using MySQL Workbench and R software, while information about the data such as clinical features was analyzed.

Results  A total of 11 488 AE reports of hypertension associated with 9 VEGFR-TKIs as the primary suspected drugs were detected. The proportion of patients over 65 years old (43.11%) and the proportion of hypertension associated with sunitinib (23.62%) were the highest in AE reports of hypertension. 9 VEGFR-TKIs were detected with hypertension related events signs. The signals of lenvatinib were the most strong among hypertension cases associated with 9 VEGFR-TKIs. AE of hypertension mostly occurred within 30 days after VEGFR-TKIs therapy.

Conclusions The AE signals of hypertension associated with antiangiogenic TKIs were very intense. Blood pressure should be supervised more closely. It is of great significance that patients should be educated to conduct self-monitoring of blood pressure when starting VEGFR-TKIs treatment.

Full-text
Please download the PDF version to read the full text: download
References

1.Enokida T, Tahara M. Management of VEGFR-targeted TKI for thyroid cancer[J]. Cancers (Basel), 2021, 13(21): 5536. DOI: 10.3390/cancers13215536.

2.Iwasa S, Okita N, Kuchiba A, et al. Phase II study of lenvatinib for metastatic colorectal cancer refractory to standard chemotherapy: the LEMON study (NCCH1503)[J].

ESMO Open, 2020, 5(4): e000776. DOI: 10.1136/esmoopen-2020-000776.

3.Jiang H, Liao J, Wang L, et al. The multikinase inhibitor axitinib in the treatment of advanced hepatocellular carcinoma: the current clinical applications and the molecular mechanisms[J]. Front Immunol, 2023, 14: 1163967. DOI: 10.3389/fimmu.2023.1163967.

4.Nakaigawa N, Tomita Y, Tamada S, et al. Final efficacy and safety results and biomarker analysis of a phase 2 study of cabozantinib in Japanese patients with advanced renal cell carcinoma[J]. Int J Clin Oncol, 2023, 28(3): 416-426. DOI: 10.1007/s10147-022-02283-w.

5.Massey PR, Okman JS, Wilkerson J, et al. Tyrosine kinase inhibitors directed against the vascular endothelial growth factor receptor (VEGFR) have distinct cutaneous toxicity profiles: a meta-analysis and review of the literature[J]. Support Care Cancer, 2015, 23(6): 1827-1835. DOI: 10.1007/s00520-014-2520-9.

6.Van Wynsberghe M, Flejeo J, Sakhi H, et al. Nephrotoxicity of anti-angiogenic therapies[J]. Diagnostics (Basel), 2021, 11(4): 640. DOI: 10.3390/diagnostics11040640.

7.Liu B, Ding F, Liu Y, et al. Incidence and risk of hypertension associated with vascular endothelial growth factor receptor tyrosine kinase inhibitors in cancer patients: a comprehensive network meta-analysis of 72 randomized controlled trials involving 30013 patients[J]. Oncotarget, 2016, 7(41): 67661-67673. DOI: 10.18632/oncotarget.11813.

8.Shah RR. Anti-angiogenic tyrosine kinase inhibitors and reversible posterior leukoencephalopathy syndrome: could hypomagnesaemia be the trigger?[J]. Drug Saf, 2017, 40(5): 373-386. DOI: 10.1007/s40264-017-0508-3.

9.Ptinopoulou AG, Sprangers B. Tyrosine kinase inhibitor-induced hypertension-marker of anti-tumour treatment efficacy or cardiovascular risk factor?[J]. Clin Kidney J, 2021, 14(1): 14-17. DOI: 10.1093/ckj/sfaa174.

10.CIOMS Working Group. Practical aspects of signal detection in pharmacovigilance[M]. Geneva: Council for International Organizations of Medical Sciences (CIOMS), 2010: 20-24.

11.Kumar A. The newly available FAERS public dashboard: implications for health care professionals[J]. Hosp Pharm, 2019, 54(2): 75-77. DOI:10.1177/0018578718795271.

12.Food and Drug Administration. FDA Adverse Event Reporting System (FAERS) quarterly data extract files (2020)[EB/OL]. (2021-03-18)[2023-02-01]. https://fis.fda.gov/extensions/FPD-QDE-FAERS/FPD-QDE-FAERS.html.

13.International Council for Harmonisation. Medical Dictionary for Regulatory Activities[EB/OL]. (2021-03-18)[2023-02-01]. https://www.meddra.org/.

14.Harpaz R, DuMouchel W, LePendu P, et al. Performance of pharmacovigilance signal-detection algorithms for the FDA adverse event reporting system[J]. Clin Pharmacol Ther, 2013, 93(6): 539-546. DOI: 10.1038/clpt.2013.24.

15.Hu Y, Bai Z, Tang Y, et al. Fournier gangrene associated with sodium-glucose cotransporter-2 inhibitors: a pharmacovigilance study with data from the U.S. FDA Adverse Event Reporting System[J]. J Diabetes Res, 2020, 2020: 3695101. DOI: 10.1155/2020/3695101.

16.van Puijenbroek EP, Bate A, Leufkens HGM, et al. A comparison of measures of disproportionality for signal detection in spontaneous reporting systems for adverse drug reactions[J]. Pharmacoepidemiology and Drug Safety, 2002, 11(1): 3-10. DOI: https://doi.org/10.1002/pds.668.

17.Kadowaki H, Ishida J, Akazawa H, et al. Axitinib induces and aggravates hypertension regardless of prior treatment with tyrosine kinase inhibitors[J]. Circ Rep, 2021, 3(4): 234-240. DOI: 10.1253/circrep.CR-21-0008.

18.Totzeck M, Mincu RI, Mrotzek S, et al. Cardiovascular diseases in patients receiving small molecules with anti-vascular endothelial growth factor activity: a meta-analysis of approximately 29,000 cancer patients[J]. Eur J Prev Cardiol, 2018, 25(5): 482-494. DOI: 10.1177/2047 487318755193.

19.Furuya-Kanamori L, Doi SA, Onitilo A, et al. Is there truly an increase in risk of cardiovascular and hematological adverse events with vascular endothelial growth factor receptor tyrosine kinase inhibitors?[J]. Expert Opin Drug Saf, 2020, 19(2): 223-228. DOI: 10.1080/ 14740338.2020.1691167.

20.Goldman A, Bomze D, Dankner R, et al. Cardiovascular toxicities of antiangiogenic tyrosine kinase inhibitors: a retrospective, pharmacovigilance study[J]. Target Oncol, 2021, 16(4): 471-483. DOI: 10.1007/s11523-021-00817-2.

21.Hou W, Ding M, Li X, et al. Comparative evaluation of cardiovascular risks among nine FDA-approved VEGFR-TKIs in patients with solid tumors: a Bayesian network analysis of randomized controlled trials[J]. J Cancer Res Clin Oncol, 2021, 147(8): 2407-2420. DOI: 10.1007/s00432-021-03521-w.

22.Dong M, Wang R, Sun P, et al. Clinical significance of hypertension in patients with different types of cancer treated with antiangiogenic drugs[J]. Oncol Lett, 2021, 21(4): 315. DOI: 10.3892/ol.2021.12576.

23.Choueiri TK, Escudier B, Powles T, et al. Cabozantinib versus everolimus in advanced renal cell carcinoma (METEOR): final results from a randomised, open-label, phase 3 trial[J]. Lancet Oncol, 2016, 17(7): 917-927. DOI: 10.1016/s1470-2045(16)30107-3.

24.Choueiri TK, Halabi S, Sanford BL, et al. Cabozantinib Versus Sunitinib As Initial Targeted Therapy for Patients With Metastatic Renal Cell Carcinoma of Poor or Intermediate Risk: The Alliance A031203 CABOSUN Trial[J]. J Clin Oncol, 2017, 35(6): 591-597. DOI: 10.1200/jco.2016.70.7398.

25.Steingart RM, Bakris GL, Chen HX, et al. Management of cardiac toxicity in patients receiving vascular endothelial growth factor signaling pathway inhibitors[J]. Am Heart J, 2012, 163(2): 156-163. DOI: 10.1016/j.ahj.2011.10.018.

26.Touyz RM, Herrmann SMS, Herrmann J. Vascular toxicities with VEGF inhibitor therapies-focus on hypertension and arterial thrombotic events[J]. J Am Soc Hypertens, 2018, 12(6): 409-425. DOI: 10.1016/j.jash.2018.03.008.

27.Kalaitzidis RG, Elisaf MS. Uncontrolled hypertension and oncology: clinical tips[J]. Curr Vasc Pharmacol, 2017, 16(1): 23-29. DOI: 10.2174/1570161115666170414121436.

28.Penttilä P, Rautiola J, Poussa T, et al. Angiotensin inhibitors as treatment of sunitinib/pazopanib-induced hypertension in metastatic renal cell carcinoma[J]. Clin Genitourin Cancer, 2017, 15(3): 384-390. DOI: 10.1016/j.clgc.2016.12.016.

29.Touyz RM, Lang NN. Hypertension and antiangiogenesis: the janus face of vegf inhibitors[J]. JACC CardioOncol, 2019, 1(1): 37-40. DOI: 10.1016/j.jaccao.2019.08.010.

Popular papers
Last 6 months