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Cardiac and renal complications of carfilzomib in patients with multiple myeloma.

TitleCardiac and renal complications of carfilzomib in patients with multiple myeloma.
Publication TypeJournal Article
Year of Publication2017
AuthorsDimopoulos, M. A., Roussou M., Gavriatopoulou M., Psimenou E., Ziogas D., Eleutherakis-Papaiakovou E., Fotiou D., Migkou M., Kanellias N., Panagiotidis I., Ntalianis A., Papadopoulou E., Stamatelopoulos K., Manios E., Pamboukas C., Kontogiannis S., Terpos E., & Kastritis E.
JournalBlood Adv
Volume1
Issue7
Pagination449-454
Date Published2017 Feb 28
ISSN2473-9529
Abstract

Clinical trials with carfilzomib have indicated a low but reproducible incidence of cardiovascular and renal toxicities. Among 60 consecutive myeloma patients treated with carfilzomib-based regimens who were thoroughly evaluated for cardiovascular risk factors, 12% (95% confidence interval, 3.8%-20%) experienced a reversible reduction of left ventricular ejection fraction (LVEF) by ≥20%, an objective measure of cardiac dysfunction. The incidence of LVEF reduction was 5% at 3 months, 8% at 6 months, 10% at 12 months, and 12% at 15 months, whereas the respective carfilzomib discontinuation rate unrelated to toxicity was 17%, 35%, 41%, and 49%. The presence of any previously known cardiovascular disease was associated with an increased incidence of cardiac events (23.5% vs 7%; = .07), but there was no association with the dose of carfilzomib or the duration of infusion. Re-treatment with carfilzomib at lower doses was possible. Carfilzomib was commonly associated with a transient reduction of estimated glomerular filtration rate (eGFR) but also improved renal function in 55% of patients with baseline eGFR <60 mL/min/1.73 m. Further investigation is needed to elucidate the underlying mechanisms of carfilzomib-related cardiorenal toxicity.

DOI10.1182/bloodadvances.2016003269
Alternate JournalBlood Adv
PubMed ID29296960
PubMed Central IDPMC5738981

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