Cargando…
Management of hypertension during lenvatinib for advanced thyroid cancer: a suggested diagnostic and therapeutic algorithm
BACKGROUND: Hypertension (HTN) is the most frequent adverse event during treatment with lenvatinib (LEN), but data on its best management are limited. AIM: The objective of this study was to assess incidence, features and best management of LEN-related HTN in a consecutive single tertiary-care centr...
Autores principales: | , , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Bioscientifica Ltd
2023
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10308446/ https://www.ncbi.nlm.nih.gov/pubmed/37097040 http://dx.doi.org/10.1530/ETJ-23-0047 |
_version_ | 1785066246082920448 |
---|---|
author | Colombo, Carla Ceruti, Daniele De Leo, Simone Bilo, Grzegorz Trevisan, Matteo Giancola, Noemi Moneta, Claudia Parati, Gianfranco Persani, Luca Fugazzola, Laura |
author_facet | Colombo, Carla Ceruti, Daniele De Leo, Simone Bilo, Grzegorz Trevisan, Matteo Giancola, Noemi Moneta, Claudia Parati, Gianfranco Persani, Luca Fugazzola, Laura |
author_sort | Colombo, Carla |
collection | PubMed |
description | BACKGROUND: Hypertension (HTN) is the most frequent adverse event during treatment with lenvatinib (LEN), but data on its best management are limited. AIM: The objective of this study was to assess incidence, features and best management of LEN-related HTN in a consecutive single tertiary-care centre cohort. METHODS: Twenty-nine patients were followed up for a mean time of 29.8 months (6–77 months). RESULTS: After a mean follow-up of 6.8 months, HTN was recorded in 76% of cases, as a de novo occurrence in half of them. HTN significantly correlated with LEN dose and was of grade 1, grade 2 and grade 3 in 5%, 50% and 45% of patients, respectively. The majority (77%) of patients with HTN developed proteinuria. There was no correlation between HTN and proteinuria or clinical features or best morphological response or any other adverse event (AE), with the exception of diarrhoea. Patients with or without pre-existing HTN or any other cardiovascular disease had a similar incidence of HTN during LEN, thus excluding the impact of this potential predisposing factor. After evaluation by a dedicated cardiologist, medical treatment was introduced in 21/22 patients (polytherapy in 20 of them). The most frequently used drugs were calcium channel blockers (CCBs) due to their effect on vasodilation. In case of poor control, CCBs were associated with one or more anti-hypertensive drug. CONCLUSION: HTN is a frequent and early AE in patients on LEN treatment. We suggest a diagnostic and therapeutic algorithm to be applied in clinical practice to allow efficient HTN control and improve patient compliance, reducing LEN discontinuation. |
format | Online Article Text |
id | pubmed-10308446 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Bioscientifica Ltd |
record_format | MEDLINE/PubMed |
spelling | pubmed-103084462023-06-30 Management of hypertension during lenvatinib for advanced thyroid cancer: a suggested diagnostic and therapeutic algorithm Colombo, Carla Ceruti, Daniele De Leo, Simone Bilo, Grzegorz Trevisan, Matteo Giancola, Noemi Moneta, Claudia Parati, Gianfranco Persani, Luca Fugazzola, Laura Eur Thyroid J Research BACKGROUND: Hypertension (HTN) is the most frequent adverse event during treatment with lenvatinib (LEN), but data on its best management are limited. AIM: The objective of this study was to assess incidence, features and best management of LEN-related HTN in a consecutive single tertiary-care centre cohort. METHODS: Twenty-nine patients were followed up for a mean time of 29.8 months (6–77 months). RESULTS: After a mean follow-up of 6.8 months, HTN was recorded in 76% of cases, as a de novo occurrence in half of them. HTN significantly correlated with LEN dose and was of grade 1, grade 2 and grade 3 in 5%, 50% and 45% of patients, respectively. The majority (77%) of patients with HTN developed proteinuria. There was no correlation between HTN and proteinuria or clinical features or best morphological response or any other adverse event (AE), with the exception of diarrhoea. Patients with or without pre-existing HTN or any other cardiovascular disease had a similar incidence of HTN during LEN, thus excluding the impact of this potential predisposing factor. After evaluation by a dedicated cardiologist, medical treatment was introduced in 21/22 patients (polytherapy in 20 of them). The most frequently used drugs were calcium channel blockers (CCBs) due to their effect on vasodilation. In case of poor control, CCBs were associated with one or more anti-hypertensive drug. CONCLUSION: HTN is a frequent and early AE in patients on LEN treatment. We suggest a diagnostic and therapeutic algorithm to be applied in clinical practice to allow efficient HTN control and improve patient compliance, reducing LEN discontinuation. Bioscientifica Ltd 2023-04-25 /pmc/articles/PMC10308446/ /pubmed/37097040 http://dx.doi.org/10.1530/ETJ-23-0047 Text en © the author(s) https://creativecommons.org/licenses/by-nc-nd/4.0/This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License. (https://creativecommons.org/licenses/by-nc-nd/4.0/) |
spellingShingle | Research Colombo, Carla Ceruti, Daniele De Leo, Simone Bilo, Grzegorz Trevisan, Matteo Giancola, Noemi Moneta, Claudia Parati, Gianfranco Persani, Luca Fugazzola, Laura Management of hypertension during lenvatinib for advanced thyroid cancer: a suggested diagnostic and therapeutic algorithm |
title | Management of hypertension during lenvatinib for advanced thyroid cancer: a suggested diagnostic and therapeutic algorithm |
title_full | Management of hypertension during lenvatinib for advanced thyroid cancer: a suggested diagnostic and therapeutic algorithm |
title_fullStr | Management of hypertension during lenvatinib for advanced thyroid cancer: a suggested diagnostic and therapeutic algorithm |
title_full_unstemmed | Management of hypertension during lenvatinib for advanced thyroid cancer: a suggested diagnostic and therapeutic algorithm |
title_short | Management of hypertension during lenvatinib for advanced thyroid cancer: a suggested diagnostic and therapeutic algorithm |
title_sort | management of hypertension during lenvatinib for advanced thyroid cancer: a suggested diagnostic and therapeutic algorithm |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10308446/ https://www.ncbi.nlm.nih.gov/pubmed/37097040 http://dx.doi.org/10.1530/ETJ-23-0047 |
work_keys_str_mv | AT colombocarla managementofhypertensionduringlenvatinibforadvancedthyroidcancerasuggesteddiagnosticandtherapeuticalgorithm AT cerutidaniele managementofhypertensionduringlenvatinibforadvancedthyroidcancerasuggesteddiagnosticandtherapeuticalgorithm AT deleosimone managementofhypertensionduringlenvatinibforadvancedthyroidcancerasuggesteddiagnosticandtherapeuticalgorithm AT bilogrzegorz managementofhypertensionduringlenvatinibforadvancedthyroidcancerasuggesteddiagnosticandtherapeuticalgorithm AT trevisanmatteo managementofhypertensionduringlenvatinibforadvancedthyroidcancerasuggesteddiagnosticandtherapeuticalgorithm AT giancolanoemi managementofhypertensionduringlenvatinibforadvancedthyroidcancerasuggesteddiagnosticandtherapeuticalgorithm AT monetaclaudia managementofhypertensionduringlenvatinibforadvancedthyroidcancerasuggesteddiagnosticandtherapeuticalgorithm AT paratigianfranco managementofhypertensionduringlenvatinibforadvancedthyroidcancerasuggesteddiagnosticandtherapeuticalgorithm AT persaniluca managementofhypertensionduringlenvatinibforadvancedthyroidcancerasuggesteddiagnosticandtherapeuticalgorithm AT fugazzolalaura managementofhypertensionduringlenvatinibforadvancedthyroidcancerasuggesteddiagnosticandtherapeuticalgorithm |