1
|
Long P, Li S, Pan L, Wang Y, Chen W, Wang X. Cardiovascular adverse events associated with antibody-drug conjugates (ADCs): a pharmacovigilance study based on the FAERS database. Front Pharmacol 2024; 15:1378010. [PMID: 38766629 PMCID: PMC11099241 DOI: 10.3389/fphar.2024.1378010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Accepted: 04/15/2024] [Indexed: 05/22/2024] Open
Abstract
Objective As a novel drug formulation, antibody drug conjugates (ADCs) are widely used in various types of cancer. However, clinically, there is a lack of attention to the CVD produced by them, as well as a lack of research on the real-world situation. Using the Food and Drug Administration Adverse Event Reporting System (FAERS) database, to ensure its clinical safety application, we analyzed post-marketing data on antitumor ADCs to identify risk factors and drugs associated with the risk of cardiovascular events. Research design and methods We used OpenVigil 2.1 to conduct a database query for adverse events (AEs) reported to the FAERS database between the time the drug was launched and the second quarter of 2023. Cardiovascular adverse events (AEs) were grouped into fourteen narrow categories using the Standardized Medical Dictionary for Regulatory Activities (MedDRA) Queries (SMQs), and the reporting odds ratio (ROR) and the proportional reporting ratio (PRR) for reporting the association between different drugs and cardiovascular disease (CVD) risk were calculated. Results In the FAERS database, 1863 AEs associated with CVD we studied were identified in patients receiving ADC therapy. Most reports came from people aged ≥65, but a significant number of cases were found to be unknown. The number of patients with antibody-drug conjugates (ADCs)-related CVD cases aged <18 years, 18-64 years, and≥ 65 years was 52 (2.79%), 586 (31.45%), and 613 (32.90%), respectively. The proportion of female patients (834, 44.77%) was higher than that of male patients (752, 40.37%). Death (770 reports), disability (9 reports), Hospitalization initial or prolonged (407 reports), and life-threatening reactions (187 reports). Of the 770 deaths reported, 103 (31.7%) were associated with brentuximab vedotin, 10 (24.4%) with sacituzumab govitecan, 22 (19.3%) with enfortumab vedotin, and 35 (34.7%) with trastuzumab emtansine.49 (41.2%) cases were associated with polatuzumab vedotin, 62 (29%) with trastuzumab deruxtecan, 423 (54.3%) with gemtuzumab ozogamicin, and 66 (38.8%) with inotuzumab ozogamicin. In a disproportionate number of SMQS, cardiac failure (n = 277) and embolic and thrombotic events, venous (n = 446) were the most frequently reported CVD-related AEs in ADCs. Conclusion By mining the FAERS database, we provided relevant information on the association between ADC use and cardiovascular-associated AEs. ADCs were associated with increased cardiovascular toxicity, deserving distinct monitoring and appropriate management. Further research is needed to confirm these findings and assess causality.
Collapse
Affiliation(s)
- PingPing Long
- School of Pharmacy and Bioengineering, Chongqing University of Technology, Chongqing, China
| | - Siyu Li
- Department of Pharmacy, Chongqing University Cancer Hospital, Chongqing, China
| | - Lingyun Pan
- Department of Pharmacy, Chongqing University Cancer Hospital, Chongqing, China
| | - Yuanqiang Wang
- School of Pharmacy and Bioengineering, Chongqing University of Technology, Chongqing, China
| | - Wanyi Chen
- Department of Pharmacy, Chongqing University Cancer Hospital, Chongqing, China
| | - Xiaoxiao Wang
- Department of Pharmacy, Chongqing University Cancer Hospital, Chongqing, China
| |
Collapse
|
2
|
Contiero P, Boffi R, Borgini A, Fabiano S, Tittarelli A, Mian M, Vittadello F, Epifani S, Ardizzone A, Cirilli C, Boschetti L, Marguati S, Cascone G, Tumino R, Fanetti AC, Giumelli P, Candela G, Scuderi T, Castelli M, Bongiorno S, Barigelletti G, Perotti V, Veronese C, Turazza F, Crivaro M, Tagliabue G. Causes of death in women with breast cancer: a risks and rates study on a population-based cohort. Front Oncol 2023; 13:1270877. [PMID: 38023134 PMCID: PMC10646497 DOI: 10.3389/fonc.2023.1270877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Accepted: 10/09/2023] [Indexed: 12/01/2023] Open
Abstract
Introduction The increasing survival of patients with breast cancer has prompted the assessment of mortality due to all causes of death in these patients. We estimated the absolute risks of death from different causes, useful for health-care planning and clinical prediction, as well as cause-specific hazards, useful for hypothesis generation on etiology and risk factors. Materials and methods Using data from population-based cancer registries we performed a retrospective study on a cohort of women diagnosed with primary breast cancer. We carried out a competing-cause analysis computing cumulative incidence functions (CIFs) and cause-specific hazards (CSHs) in the whole cohort, separately by age, stage and registry area. Results The study cohort comprised 12,742 women followed up for six years. Breast cancer showed the highest CIF, 13.71%, and cardiovascular disease was the second leading cause of death with a CIF of 3.60%. The contribution of breast cancer deaths to the CIF for all causes varied widely by age class: 89.25% in women diagnosed at age <50 years, 72.94% in women diagnosed at age 50-69 and 48.25% in women diagnosed at age ≥70. Greater CIF variations were observed according to stage: the contribution of causes other than breast cancer to CIF for all causes was 73.4% in women with stage I disease, 42.9% in stage II-III and only 13.2% in stage IV. CSH computation revealed temporal variations: in women diagnosed at age ≥70 the CSH for breast cancer was equaled by that for cardiovascular disease and "other diseases" in the sixth year following diagnosis, and an early peak for breast cancer was identified in the first year following diagnosis. Among women aged 50-69 we identified an early peak for breast cancer followed by a further peak near the second year of follow-up. Comparison by geographic area highlighted conspicuous variations: the highest CIF for cardiovascular disease was more than 70% higher than the lowest, while for breast cancer the highest CIF doubled the lowest. Conclusion The integrated interpretation of absolute risks and hazards suggests the need for multidisciplinary surveillance and prevention using community-based, holistic and well-coordinated survivorship care models.
Collapse
Affiliation(s)
- Paolo Contiero
- Environmental Epidemiology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Roberto Boffi
- Respiratory Disease Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy
| | - Alessandro Borgini
- Environmental Epidemiology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Sabrina Fabiano
- Cancer Registry Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Andrea Tittarelli
- Cancer Registry Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Michael Mian
- Innovation, Research and Teaching Service, Hospital of Bolzano (SABES-ASDAA), Teaching Hospital of the Paracelsus Medizinischen Privatuniversität (PMU), Bozen, Italy
| | | | - Susi Epifani
- Statistics and Epidemiology Unit, ASL Brindisi, Brindisi, Italy
| | | | - Claudia Cirilli
- Servizio di Epidemiologia e Comunicazione del Rischio-Unità Funzionale di Modena, Registro Tumori Regione, Modena, Italy
| | | | - Stefano Marguati
- Pavia Cancer Registry, Public Health Agency of Pavia, Pavia, Italy
| | - Giuseppe Cascone
- Ragusa Cancer Registry Unit, Azienda Sanitaria Provinciale di Ragusa (ASP), Ragusa, Italy
| | - Rosario Tumino
- Ragusa Cancer Registry Unit, Azienda Sanitaria Provinciale di Ragusa (ASP), Ragusa, Italy
| | | | | | | | | | - Maurizio Castelli
- Dipartimento di Prevenzione Azienda USL Valle d’Aosta Loc, Quart, Italy
| | | | - Giulio Barigelletti
- Cancer Registry Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Viviana Perotti
- Cancer Registry Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Chiara Veronese
- Respiratory Disease Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy
| | - Fabio Turazza
- Cardiology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Marina Crivaro
- Cardiology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Giovanna Tagliabue
- Cancer Registry Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | | |
Collapse
|
3
|
Garcia-Unciti M, Palacios Samper N, Méndez-Sandoval S, Idoate F, Ibáñez-Santos J. Effect of Combining Impact-Aerobic and Strength Exercise, and Dietary Habits on Body Composition in Breast Cancer Survivors Treated with Aromatase Inhibitors. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4872. [PMID: 36981785 PMCID: PMC10049091 DOI: 10.3390/ijerph20064872] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 03/06/2023] [Accepted: 03/08/2023] [Indexed: 06/18/2023]
Abstract
This study examines both the effect of a twice-weekly combined exercise-1 h session of strength and 1 h session of impact-aerobic-on body composition and dietary habits after one year of treatment with aromatase inhibitors (AI) in breast cancer survivors. Overall, forty-three postmenopausal women with a BMI ≤ 35 kg/m2, breast cancer survivors treated with AI, were randomized into two groups: a control group (CG) (n = 22) and a training group (IG) (n = 21). Body composition, i.e., abdominal, visceral, and subcutaneous adipose tissue) was measured by magnetic resonance. In addition, some questionnaires were used to gather dietary data and to measure adherence to the Mediterranean diet. After one year, women in the IG showed a significant improvement in body composition, indicated by decreases in subcutaneous and visceral adipose tissue, and total fat tissue. Furthermore, the dietary habits were compatible with moderate adherence to the Mediterranean diet pattern and a low dietary intake of Ca, Zn, Folic Ac, and vitamins D, A, and E. A twice-weekly training program combining impact aerobic exercise and resistance exercise may be effective in improving the body composition for postmenopausal women who have breast cancer treated with AI, and the results suggest the need for nutritional counselling for this population.
Collapse
Affiliation(s)
- Marisol Garcia-Unciti
- Department of Nutrition, Food Sciences and Physiology, Faculty of Pharmacy and Nutrition, University of Navarra, Campus Universitario, 31008 Pamplona, Spain
- Center for Nutrition Research, University of Navarra, c/Irunlarrea 1, 31008 Pamplona, Spain
- Navarra Institute for Health Research (IdiSNA), 31008 Pamplona, Spain
| | - Natalia Palacios Samper
- Centro de Estudios, Investigación y Medicina del Deporte (CEIMD), Gobierno de Navarra, 31005 Pamplona, Spain
- Department of Gerontology and Public Health, Faculty of Health Science, University of Jyväskylä, Seminaarinkatu 15, Jyväskylän Yliopisto, 40014 Jyväskylä, Finland
- Department of Physiology, Faculty of Health Science, Public University of Navarre, Av. Cataluña, s/n, 31006 Pamplona, Spain
| | - Sofía Méndez-Sandoval
- Department of Nutrition, Food Sciences and Physiology, Faculty of Pharmacy and Nutrition, University of Navarra, Campus Universitario, 31008 Pamplona, Spain
| | - Fernando Idoate
- Servicio de Radiología de la Mutua Navarra, 31012 Pamplona, Spain;
| | - Javier Ibáñez-Santos
- Centro de Estudios, Investigación y Medicina del Deporte (CEIMD), Gobierno de Navarra, 31005 Pamplona, Spain
| |
Collapse
|
4
|
Triantafyllou A, Elia SA, Park C, Climie RE, Mayer CC, Mozos I, Pucci G, Weber T, Panayiotou AG. Developing a Questionnaire on Knowledge, Perceptions and Application of Vascular-Aging Measurements. J Cardiovasc Dev Dis 2023; 10:jcdd10020080. [PMID: 36826576 PMCID: PMC9965266 DOI: 10.3390/jcdd10020080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 01/27/2023] [Accepted: 02/08/2023] [Indexed: 02/17/2023] Open
Abstract
BACKGROUND Vascular age (VA) is independent and chronological age for assessing cardiovascular disease (CVD) risk. However, tools for the implementation of VA are currently lacking. We aimed to develop a questionnaire to assess the current knowledge gaps related to VA and barriers to its implementation in routine practice. METHODS Using a stepwise mixed-method approach, a quantitative questionnaire was constructed in four phases: (1) basic item generation and the development of a semi-qualitative questionnaire (SQQ); (2) dissemination to the VascAgeNet extended network and an analysis of the semi-qualitative questionnaire responses; (3) the development of a quantitative questionnaire (QQ); and (4) an assessment of the content and face validity and internal reliability in an additional sample. RESULTS Based on six main topics initially identified through an expert panel, a SQQ was developed and disseminated. Finally, a 22-item QQ was developed, with questions grouped around three main themes: knowledge of VA and its risk factors; perceptions and beliefs regarding the importance and contribution of VA to risk classification; and the application of VA measurements in clinical and research practice and its potential limitations (Cronbach's alpha between 0.920 and 0.982 for all three categories). CONCLUSION We report the development of a QQ on VA addressed to both clinicians and non-clinicians aiming to assess their knowledge, perceptions and application of VA measurements.
Collapse
Affiliation(s)
- Areti Triantafyllou
- 3rd Clinic of Internal Medicine, Papageorgiou Hospital, Aristotle University of Thessaloniki, 56403 Thessaloniki, Greece
| | - Stavria-Artemis Elia
- Cyprus International Institute for Environmental and Public Health, Cyprus University of Technology, 3041 Limassol, Cyprus
| | - Chloe Park
- MRC Unit for Lifelong Health and Aging, UCL, London WC1E 6BT, UK
| | - Rachel E Climie
- Menzies Institute for Medical Research, University of Tasmania, Hobart 7000, Australia
| | - Christopher C. Mayer
- Medical Signal Analysis, Center for Health & Bioresources, AIT Austrian Institute of Technology GmbH, 1210 Vienna, Austria
| | - Ioana Mozos
- Department of Functional Sciences-Pathophysiology, Center for Translational Research and Systems Medicine, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Giacomo Pucci
- Department of Medicine and Surgery, University of Perugia, Unit of Internal Medicine, Terni University Hospital, 05100 Terni, Italy
| | - Thomas Weber
- Cardiology Department, Klinikum Wels-Grieskirchen, 4600 Wels, Austria
| | - Andrie G. Panayiotou
- Cyprus International Institute for Environmental and Public Health, Cyprus University of Technology, 3041 Limassol, Cyprus
- Correspondence: ; Tel.: +357-25002131
| |
Collapse
|