risk of hypertension with pazopanib

[Olga]

Incidence and risk of hypertension with pazopanib in patients with cancer: a
meta-analysis
http://www.ncbi.nlm.nih.gov/pubmed/23178953
Abstracts
Purposes To gain a better understanding of the overall incidence and risk of
hypertension in cancer patients who receive pazopanib and to compare the
differences in incidence among sorafenib, sunitinib, and pazopanib.
Methods Several databases were searched, including PubMed, Embase, and
Cochrane databases. Eligible studies were phase II and III prospective
clinical trials of patients with cancer assigned single drug pazopanib 800
mg/day with data on hypertension available. Overall incidence rates,
relative risk (RR), and 95 % confidence intervals
(CI) were calculated employing fixed or random effects models depending on
the heterogeneity of the included trials.
Results A total of 1,651 patients with a variety of solid tumors from 13
clinical trials were included for the metaanalysis.
The overall incidences of all-grade and highgrade hypertension in cancer
patients were 35.9 % (95 % CI 31.5–40.6 %) and 6.5 % (95 % CI 5.2–8.0 %),
respectively. The use of pazopanib was associated with an increased risk of
developing all-grade (RR 4.97, 95 % CI 3.38–7.30, p\0.001) and high-grade
hypertension (RR 2.87, 95 % CI 1.16–7.12, p = 0.023). Additionally, there
was no significant difference in the incidence of all-grade (RR 1.21, 95 %
CI 0.96–1.53, p = 0.11) and high-grade hypertension (RR 1.29, 95 % CI
0.80–2.07, p = 0.30) between RCC and non-RCC patients. Interestingly, the
risk of all-grade hypertension with pazopanib was substantially higher than
sorafenib (RR 1.99; 95 % CI 1.73–2.29, p = 0.00) and sunitinib (RR 2.20; 95
% CI 1.92–2.52, p = 0.00), while the risk of pazopanib-induced high-grade
hypertension was similar to sorafenib (RR 0.98; 95 % CI 0.75–1.30, p = 0.90)
and sunitinib (RR 0.81; 95 % CI 0.62–1.06, p = 0.12).
Conclusions The use of pazopanib is associated with a significantly
increased risk of developing hypertension.
Close monitoring and appropriate managements are recommended during the
therapy. Future studies are still needed to investigate the risk reduction
and possible use of pazopanib in selected patients