Abemaciclib‐induced reversible grade 4 nephrotoxicity

Silva, Angélique Da; Chrétien, Basile; Alexandre, Jonas; Emile, George

doi:10.1111/tbj.13980

Cited by 5 publications

(1 citation statement)

References 9 publications

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“…Therefore, users of ABE may need to be treated with caution to prevent worsening of renal function. Although ABE-induced nephrotoxicity is considered rare, a case of grade 4 acute kidney injury has previously been reported [15]. ABE has been shown to inhibit creatinine transporters in renal tubules, resulting in decreased creatinine clearance and increased serum creatinine levels [16].…”

Section: Discussionmentioning

confidence: 99%

A comparison between the adverse event profiles of patients receiving palbociclib and abemaciclib: analysis of two real-world databases

Takeda,

Sugimoto,

Matsumoto

et al. 2024

Int J Clin Pharm

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Background: Palbociclib and abemaciclib are cyclin-dependent kinase (CDK) 4/6 inhibitors currently used to treat breast cancer. Although their therapeutic e cacies are considered comparable, differences of adverse event (AE) pro les between the two drugs remain unclear.Aim: We analysed two real-world databases, the World Health Organization's VigiBase and the Food and Drug Administration Adverse Event Reporting System (FAERS), to identify the differences in AE pro les between palbociclib and abemaciclib.Method: Data of patients with breast cancer receiving palbociclib or abemaciclib recorded until December 2022 were extracted from the VigiBase and FAERS databases. In total, 200 types of AEs were analysed. The reporting odds ratios were calculated using a disproportionality analysis.Results: Cytopenia was frequently reported in patients receiving palbociclib, while interstitial lung disease and diarrhoea were frequently reported in those receiving abemaciclib. Moreover, psychiatric and nervous system disorders were more common in the palbociclib group, whereas renal and urinary disorders were more common in the abemaciclib group. Conclusion:This study was the rst to show comprehensive disparities in the AE pro les between palbociclib and abemaciclib and highlighted the importance of considering these when selecting a suitable CDK4/6 inhibitor to ensure safe and favourable outcomes for patients with breast cancer. Impact statementsIn addition to cytopenia, many adverse events, including psychiatric and nervous system disorders, are potentially more frequent in patients receiving palbociclib compared to abemaciclib. Interstitial lung disease, diarrhoea, and renal and urinary disorders are potentially more frequent in patients receiving abemaciclib compared to palbociclib.The identi cation of adverse event pro les for palbociclib and abemaciclib contributes to drug selection that minimizes the risk of adverse events for individual patients.

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Section: Discussionmentioning

confidence: 99%

A comparison between the adverse event profiles of patients receiving palbociclib and abemaciclib: analysis of two real-world databases

Takeda,

Sugimoto,

Matsumoto

et al. 2024

Int J Clin Pharm

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Abemaciclib/metformin

2020

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Acute kidney injury and diarrhoea: case reportA 73-year-old woman developed acute kidney injury following concomitant administration of abemaciclib with metformin. Additionally, she developed diarrhoea during treatment with abemaciclib for hormone receptor-positive breast cancer [not all routes, duration of treatments to reactions onsets and outcomes stated].The woman was diagnosed with hormone receptor-positive (HR+) and HER2-negative (HER2-) metastatic breast cancer in February 2020. Her medical history was significant for hypercholesterolaemia, hypertension, and diabetes for which she had been receiving saxagliptin, insulin, gliclazide and oral metformin 1000mg three times daily. She started receiving abemaciclib 150mg twice daily along with letrozole. Her serum creatinine level was 0.97 mg/dL. Within two weeks after abemaciclib initiation, she developed grade 1 diarrhoea and grade 2 nausea and vomiting despite treatment with loperamide and metoclopramide. The biologic test showed a Kidney Disease Improving Global Outcomes 3 grade 4 acute kidney injury with serum creatinine level at 7.1 mg/dL and blood urea nitrogen 249 mg/dL. It was hypothesised that, a competition between metformin and abemaciclib occurred on renal transporters, which led to abemaciclib accumulation in proximal tubule epithelial cells and caused acute kidney injury.The woman's treatment with abemaciclib was discontinued. Renal workup showed blood urea nitrogen/serum creatinine ratio 66, urine sodium 55 mmol/L and fractional excretion of sodium 5%, confirmed the diagnosis of acute tubular necrosis. Due to serum creatinine aggravation and anuria, she was dialyzed twice. Her treatment with metformin was discontinued. After haemodialysis, her renal function recovered.

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