Syndrome of Inappropriate Secretion of Antidiuretic Hormone Associated with Imatinib

Liapis, Konstantinos; Apostolidis, John; Charitaki, Evangelia; Panitsas, Fotios; Harhalakis, Nikolaos; Nikiforakis, Emmanuel

doi:10.1345/aph.1l410

Cited by 27 publications

(20 citation statements)

References 21 publications

(1 reference statement)

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“…7 In a previously reported case of SIADH due to imatinib, the authors theorized the patient could have experienced increased plasma concentrations of imatinib due to concurrent administration of omeprazole (a cytochrome P450 (CYP) 3A4 substrate and weak inhibitor and p-glycoprotein (P-gp) substrate inhibitor) and imatinib which is primarily metabolized by CYP 3A4 and also a P-gp substrate and inhibitor. 2 Using this theory, it is reasonable to assume a similar interaction could have occurred with our patient who was also receiving a proton-pump inhibitor, rabeprazole. The degree of interaction would theoretically be less with rabeprazole as it is thought to have less CYP3A4 metabolism than omeprazole; however, this increased drug exposure could have led to the SIADH experienced by the patient.…”

Section: Discussionmentioning

confidence: 80%

Tyrosine kinase inhibitor-associated syndrome of inappropriate secretion of anti-diuretic hormone

Hill

Shields

Passero

2016

J Oncol Pharm Pract

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Hyponatremia is a common complication among cancer patients. Certain antineoplastic agents have been associated with syndrome of inappropriate secretion of anti-diuretic hormone-induced hyponatremia. The most common agents associated with secretion of anti-diuretic hormone are vinca alkaloids, platinum compounds, and alkylating agents. We report a case of secretion of anti-diuretic hormone associated with tyrosine kinase inhibitors.

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Section: Discussionmentioning

confidence: 80%

Tyrosine kinase inhibitor-associated syndrome of inappropriate secretion of anti-diuretic hormone

Hill

Shields

Passero

2016

J Oncol Pharm Pract

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“…Tyrosine Kinase Inhibitors (TKI) treatment has been associated with SIADH. Hyponatremia-related SIADH was reported in patients affected by Bcr-Abl acute lymphoblastic leukemia treated by Imatinib at a dose of 400 mg/day, and was observed after 11 months of therapy (81), in those affected by refractory chronic myelogenous leukemia treated with Dasatinib (100 mg/day), Nilotinib (400 mg twice/day) and Bosutinib (500 mg/day) (82), as well as in patients with renal carcinoma or with metastatic head and neck cancer treated with Sorafenib (400 mg twice/day for a median duration of therapy of 3.4 months) (83). Mammalian targets of rapamycin (mTOR) inhibitors.…”

Section: Target Therapiesmentioning

confidence: 99%

Electrolyte Disorders Induced by Antineoplastic Drugs

et al. 2020

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The use of antineoplastic drugs has a central role in treatment of patients affected by cancer but is often associated with numerous electrolyte derangements which, in many cases, could represent life-threatening conditions. In fact, while several anti-cancer agents can interfere with kidney function leading to acute kidney injury, proteinuria, and hypertension, in many cases alterations of electrolyte tubular handling and water balance occur. This review summarizes the mechanisms underlying the disturbances of sodium, potassium, magnesium, calcium, and phosphate metabolism during anti-cancer treatment. Platinum compounds are associated with sodium, potassium, and magnesium derangements while alkylating agents and Vinca alkaloids with hyponatremia due to syndrome of inappropriate antidiuretic hormone secretion (SIADH). Novel anti-neoplastic agents, such as targeted therapies (monoclonal antibodies, tyrosine kinase inhibitors, immunomodulators, mammalian target of rapamycin), can induce SIADH-related hyponatremia and, less frequently, urinary sodium loss. The blockade of epidermal growth factor receptor (EGFR) by anti-EGFR antibodies can result in clinically significant magnesium and potassium losses. Finally, the tumor lysis syndrome is associated with hyperphosphatemia, hypocalcemia and hyperkalemia, all of which represent serious complications of chemotherapy. Thus, clinicians should be aware of these side effects of antineoplastic drugs, in order to set out preventive measures and start appropriate treatments.

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“…Other causes of SIADH include surgery (intense pain and post‐operative nausea stimulate secretion of AVP) and drugs. Among the most commonly drugs are antidepressants (amitriptyline, citalopram and fluoxetine), non‐steroidal anti‐inflammatory drugs, chlorpropamide, tolbutamide, clofibrate, cyclophosphamide, ciprofloxacin, interferon‐alpha, interferon‐gamma, carbamazepine, amiodarone, morphine, amphetamines and ‘ecstasy’ …”

Section: Resultsmentioning

confidence: 99%

Employment of vasopressin receptor antagonists in management of hyponatraemia and volume overload in some clinical conditions

2015

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SUMMARYWhat is known and objective: Hyponatraemia, the most common electrolyte imbalance occurring in hospitalized subjects, is usually classified as hypovolaemic, euvolaemic or hypervolaemic. Hyponatraemia is a predictor of death among subjects with chronic heart failure and cirrhosis. The inappropriate secretion of the antidiuretic hormone (AVP) seems to be of pivotal importance in the decline of serum sodium concentration in these clinical conditions. The objective of this review was to summarize recent progress in management of hyponatraemia in SIADH, cirrhosis and heart failure. Methods: Literature searches were conducted on the topics of hyponatraemia and vasopressin receptor antagonists, using PubMed, pharmaceutical company websites and news reports. The information was evaluated for relevance and quality, critically assessed and summarized. Results and discussion: The initial treatment of severe hyponatraemia is directed towards the prevention or management of neurological manifestations and consists of an intravenous infusion of hypertonic saline. Fluid restriction is indicated in oedematous states. Diuretics alone or in combination with other specific drugs remain the main strategy in the management of volume overload in heart failure. In resistant cases, ultrafiltration can lead to effective removal of isotonic fluid preventing new episodes of decompensation; however, aquapheresis is associated with increased costs and other limits. In several trials, the efficacy of vasopressin receptor antagonists in euvolaemic patients (inappropriate antidiuretic hormone secretion) or in hypervolaemic hyponatraemia (chronic heart failure, cirrhosis) has been evaluated. It was found that vaptans, which promote aquaresis, were superior to a placebo in raising and maintaining serum sodium concentrations in these subjects. What is new and conclusions: Combined with conventional therapy, vasopressin receptor antagonists (AVP-R antagonists) are able to increase the excretion of electrolyte-free water and the sodium concentration. Further studies are needed to assess efficacious outcomes of aquaresis compared with aquapheresis and with conventional therapy. WHAT IS KNOWN AND OBJECTIVEHyponatraemia is variably defined, but a serum sodium concentration below 135 mEq/L is the cut-off most frequently used.1 It is the most common electrolyte imbalance present in hospitalized subjects, with an incidence of 15-22% for values of serum sodium <135 mEq/L and of 1-4% for values <130 mEq/L.2,3 Hyponatraemia is associated with increased morbidity and mortality among subjects with heart, liver or neurologic disease. 4-7The prevalence of hyponatraemia varies widely depending on the clinical setting. The highest frequencies are observed in intensive care units (ICU), in the post-operative setting and in older subjects admitted to geriatric wards. In the latter, this alteration is associated with different compliances and it is due to age-related physiological changes in water and electrolyte balance, as well as in the presence of comorbi...

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Syndrome of Inappropriate Secretion of Antidiuretic Hormone Associated with Imatinib

Abstract: We recommend monitoring for SIADH if a patient receiving high-dose imatinib develops hyponatremia.

Cited by 27 publications

References 21 publications

Tyrosine kinase inhibitor-associated syndrome of inappropriate secretion of anti-diuretic hormone

Tyrosine kinase inhibitor-associated syndrome of inappropriate secretion of anti-diuretic hormone

Electrolyte Disorders Induced by Antineoplastic Drugs

Employment of vasopressin receptor antagonists in management of hyponatraemia and volume overload in some clinical conditions

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