Pharmaceutical Prevention and Management of Cardiotoxicity in Hematological Malignancies

Perpinia, Anastasia; Kadoglou, Nikolaos P.E.; Vardaka, Maria; Gkortzolidis, Georgios; Karavidas, Apostolos; Marinakis, Theodoros; Papachrysostomou, Chrysostomi; Makaronis, Panagiotis; Vlachou, Charikleia; Mantzourani, Marina; Farmakis, Dimitrios; Κωνσταντόπουλος, Κωνσταντίνος

doi:10.3390/ph15081007

Cited by 4 publications

(6 citation statements)

References 126 publications

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“…Cardiac disorders are common clinical conditions associated with high mortality rates (Shinomoto et al, 2022). There are many manifestations such as torsade de pointes, long qt syndrome, ventricular tachycardia and cardiac failure (Perpinia et al, 2022). Many possible mechanisms are related to the occurrence of TAA-induced cardiac disorders.…”

Section: Introductionmentioning

confidence: 99%

Evaluating cardiac disorders associated with triazole antifungal agents based on the US Food and Drug Administration Adverse Event reporting system database

Chen,

Xu,

et al. 2024

Front. Pharmacol.

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Introduction:Triazole antifungal agents are widely used to treat and prevent systemic mycoses. With wide clinical use, the number of reported adverse events has gradually increased. The aim of this study was to analyze the cardiac disorders associated with TAAs (fluconazole, voriconazole, itraconazole, posaconazole and isavuconazole) based on data from the US Food and Drug Administration Adverse Event Reporting System FDA Adverse Event Reporting System.Methods:Data were extracted from the FAERS database between the first quarter of 2004 and third quarter of 2022. The clinical characteristics in TAA-associated cardiac AE reports were analyzed. Disproportionality analysis was performed to evaluate the potential association between AEs and TAAs using the reporting odds ratio (ROR) and proportional reporting ratio (PRR).Results:Among 10,178,522 AE reports, 1719 reports were TAA-associated cardiac AEs as primary suspect drug. Most reports were related to fluconazole (38.34%), voriconazole (28.56%) and itraconazole (26.76%). Itraconazole (N = 195, 42.39%) and isavuconazole (N = 2, 14.29%) had fewer serious outcome events than three other drugs including fluconazole, voriconazole, and posaconazole. 13, 11, 26, 5 and 1 signals were detected for fluconazole, voriconazole, itraconazole, posaconazole and isavuconazole, respectively. The number of new signals unrecorded in the drug label was 9, 2, 13, 2 and 0 for fluconazole, voriconazole, itraconazole, posaconazole and isavuconazole, respectively.Conclusion:Isavuconazole might be the safest of the five TAAs for cardiac AEs. TAA-associated cardiac disorders may result in serious adverse outcomes. Therefore, in addition to AEs on the drug label, we should pay attention to new AEs unrecorded on the drug label during the clinical use of TAAs.

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Section: Introductionmentioning

confidence: 99%

Evaluating cardiac disorders associated with triazole antifungal agents based on the US Food and Drug Administration Adverse Event reporting system database

Chen,

Xu,

et al. 2024

Front. Pharmacol.

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“…Cardiovascular diseases are significantly more frequent among hematological patients than in the general population, mainly because of treatment side effects [2,12,32,33]. The most common cardiovascular disorder among ABC study participants was hypertension, affecting one out of five long-term survivors.…”

Section: Discussionmentioning

confidence: 97%

“…Treatment-or diseaserelated side effects, such as polyneuropathy [6,7] or an increased susceptibility to infection [8], may persist for prolonged periods of time. Cancer [9][10][11] and cardiovascular diseases [12] occur more frequently in blood cancer survivors than in the general population. Little is known about the impact of these events on the patients' lives.…”

Section: Introductionmentioning

confidence: 99%

Health-Related Complications during Follow-Up and Their Impact on Blood Cancer Survivors: Results from the “Aftercare in Blood Cancer Survivors” (ABC) Study

Baum,

Lax,

Lehmann

et al. 2024

Acta Haematol

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Introduction Blood cancer survivors are at increased risk for medical complications. Methods Our questionnaire-based study involved 1,551 blood cancer survivors with a ≥3-year interval since the last intense treatment. Its goal was to quantify health-related complications during follow-up and assess their impact on the patients’ lives. Results 20.4% of responding survivors reported a disease relapse, most often in indolent lymphomas. Second primary malignancies occurred in 14.1%, primarily in lymphoma and allogeneic transplantation survivors. The most frequent malignancy was basal cell carcinoma of the skin, but myeloid malignancies, melanoma, bladder, head-and-neck, and thyroid cancer also appeared disproportionately frequent. An increased infection rate was reported by 43.7%, most often after allogeneic transplantation. New cardiovascular diseases were reported by 30.2%, with a high rate of thromboembolic events in multiple myeloma and myeloproliferative diseases. Polyneuropathies were reported by 39.1%, most often by survivors with a history of multiple myeloma or aggressive lymphoma. Disease relapse was perceived as the highest burden, followed by second primary malignancy, increased infection frequency, and polyneuropathy. In each area investigated, the range of perceived severities was wide. Conclusions Health-related complications are frequent during blood cancer follow-up, with significant repercussions on the patients’ lives.

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“…If long-term antithrombotic therapy is required, new anticoagulants may be considered to reduce the risk of thrombosis and bleeding ( 95 ). Statins reduce the risk of damage to the central blood vessels during anthracycline treatment ( 96 ). In another retrospective analysis of clinical data from 628 patients with newly diagnosed breast cancer treated with anthracyclines, the use of statins after anthracycline therapy was found to reduce the risk of cardiotoxicity in these patients ( 97 ).…”

Section: Cardiotoxicity Preventionmentioning

confidence: 99%

Coronary atherosclerosis and chemotherapy: From bench to bedside

Zhou

Zhu

Liu

et al. 2023

Front. Cardiovasc. Med.

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Cardiovascular disease, particularly coronary artery disease, is the leading cause of death in humans worldwide. Coronary heart disease caused by chemotherapy affects the prognosis and survival of patients with tumors. The most effective chemotherapeutic drugs for cancer include proteasome inhibitors, tyrosine kinase inhibitors, immune checkpoint inhibitors, 5-fluorouracil, and anthracyclines. Animal models and clinical trials have consistently shown that chemotherapy is closely associated with coronary events and can cause serious adverse cardiovascular events. Adverse cardiovascular events after chemotherapy can affect the clinical outcome, treatment, and prognosis of patients with tumors. In recent years, with the development of new chemotherapeutic drugs, new discoveries have been made about the effects of drugs used for chemotherapy on cardiovascular disease and its related mechanisms, such as inflammation. This review article summarizes the effects of chemotherapeutic drugs on coronary artery disease and its related mechanisms to guide efforts in reducing cardiovascular adverse events during tumor chemotherapy, preventing the development of coronary heart disease, and designing new prevention and treatment strategies for cardiotoxicity caused by clinical tumor chemotherapy.

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Pharmaceutical Prevention and Management of Cardiotoxicity in Hematological Malignancies

Cited by 4 publications

References 126 publications

Evaluating cardiac disorders associated with triazole antifungal agents based on the US Food and Drug Administration Adverse Event reporting system database

Evaluating cardiac disorders associated with triazole antifungal agents based on the US Food and Drug Administration Adverse Event reporting system database

Health-Related Complications during Follow-Up and Their Impact on Blood Cancer Survivors: Results from the “Aftercare in Blood Cancer Survivors” (ABC) Study

Coronary atherosclerosis and chemotherapy: From bench to bedside

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