Hypertension:免疫检查点抑制剂不会增加癌症患者高血压的短期风险

2022-09-14 MedSci原创 MedSci原创

在癌症患者中,免疫检查点抑制剂治疗与短期高血压风险无关,且不论是否同时采用其他抗癌药物治疗,两者之间的关联是相似的。

免疫检查点抑制剂正广泛应用于新型癌症治疗。免疫相关不良事件,包括心脏毒性,在使用免疫检查点抑制剂后经常被观察到。然而,关于癌症患者开始采用免疫检查点抑制剂治疗与高血压之间的关系知之甚少。

近日,心血管权威杂志Hypertension上发表了一篇研究文章,研究人员对PubMed、EMBASE、Cochrane Library和Web of Science Core Collection数据库进行了系统地文献检索。

在随机对照试验(RCT)中评估了与免疫检查点抑制剂治疗相关的高血压风险。根据不良事件通用术语标准对高血压进行分类。研究人员采用随机效应荟萃分析计算了I级与V级和III级与V级高血压的比值比。

该研究共纳入了32项随机对照试验(n=19810例癌症患者)。在36个月的中位随访中,免疫检查点抑制剂组的中位总生存期为15个月。免疫检查点抑制剂治疗与高血压之间无显著相关性(I-V级:风险比为1.12[95%CI为0.96-1.30];III-V级:风险比为0.95[95%CI为0.78-1.16])。此外,在采用免疫检查点抑制剂与包括抗血管内皮生长因子(VEGF)药物在内的多种药物联合治疗中,高血压风险无明显差异。在基于临床背景的亚组分析中(安慰剂对照试验与非安慰剂对照试验),不同方法得到的结果存在差异,非安慰剂对照试验中的患者具有更高的I-V级高血压风险(I2=88.6%,异质性P=0.003)。

由此可见,在癌症患者中,免疫检查点抑制剂治疗与短期高血压风险无关,且不论是否同时采用其他抗癌药物治疗,两者之间的关联是相似的。

原始出处:

Shintaro Minegishi.et al.Immune Checkpoint Inhibitors Do Not Increase Short-Term Risk of Hypertension in Cancer Patients: a Systematic Literature Review and Meta-Analysis.Hypertension.2022.https://www.ahajournals.org/doi/10.1161/HYPERTENSIONAHA.122.19865

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    2023-03-09 feather89
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    2022-11-13 jklm09
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