Angiogenesis inhibitor bevacizumab increases the risk of ischemic heart disease associated with chemotherapy: a meta-analysis.
Angiogenesis inhibitor bevacizumab increases the risk of ischemic heart disease associated with chemotherapy: a meta-analysis.
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DOI：
10.1371/journal.pone.0066721
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发表时间：
2013
期刊：
影响因子：
3.7
通讯作者：
Liu YW
中科院分区：
文献类型：
--
作者：
Chen XL;Lei YH;Liu CF;Yang QF;Zuo PY;Liu CY;Chen CZ;Liu YW
新型抗血管生成剂贝伐单抗（一种广泛用于癌症治疗的血管内皮生长因子重组人源化单克隆抗体）引起了人们对缺血性心脏病风险的担忧。目前，贝伐单抗在缺血性心脏病中的作用存在争议。因此，本荟萃分析旨在评估与使用贝伐珠单抗相关的缺血性心脏病的总体风险。检索PubMed、EMBASE和Web of Science数据库中截至2012年10月25日发表的比较贝伐珠单抗与对照治疗的随机对照试验的英文研究。基于纳入研究的异质性，使用随机效应或固定效应模型计算汇总发生率、相对风险（RR）和95%置信区间（CI）。从7项随机对照试验中共确定了4，617例患者，并纳入分析。在接受贝伐珠单抗治疗的患者中，缺血性心脏病的总发生率为1.0%（95% CI，0.6%-1.4%）。与对照组相比，接受贝伐单抗治疗的患者发生缺血性心脏病的风险显著增加，RR为2.49（95%CI，1.37-4.52）。此外，高剂量和低剂量贝伐珠单抗均增加了心肌缺血的风险（低剂量2.5 mg/kg/周：RR，2.14 [95% CI，1.09-4.19];高剂量5 mg/kg/周：RR，4.81 [95% CI，1.03-22.42]）。研究还发现，与对照组相比，贝伐珠单抗显著增加结直肠癌患者的心肌缺血风险（RR，2.13; 95%CI，1.11-4.06）。这项荟萃分析显示，在接受贝伐单抗治疗的结直肠癌患者中，使用贝伐单抗与发生缺血性心脏病的风险增加相关。我们的结论受到现有数据的限制。需要进一步评价高质量的RCT。
Concerns have arisen regarding the risk of ischemic heart disease with the novel antiangiogenic agent bevacizumab, a recombinant humanised monoclonal antibody to the vascular endothelial growth factor that is widely used in cancer treatment. Currently, the role of bevacizumab in ischemic heart disease is controversial. This meta-analysis was therefore performed to assess the overall risk of ischemic heart disease associated with the use of bevacizumab. The databases of PubMed, EMBASE and Web of Science were searched for English language studies of randomised controlled trials comparing bevacizumab with control therapy published through October 25, 2012. Summary incidence rates, relative risks (RRs) and 95% confidence intervals (CIs) were calculated using random-effects or fixed-effects models based on the heterogeneity of the included studies. A total of 4,617 patients from 7 randomised controlled trials were identified and included for analysis. Among those patients receiving bevacizumab, the summary incidence of ischemic heart disease was 1.0% (95% CI, 0.6%–1.4%). Patients treated with bevacizumab had a significantly increased risk of ischemic heart disease with an RR of 2.49 (95% CI, 1.37–4.52) compared with controls. In addition, both high doses and low doses of bevacizumab increased the risk of cardiac ischemia (low dose at 2.5 mg/kg per week: RR, 2.14 [95% CI, 1.09–4.19]; high dose at 5 mg/kg per week: RR, 4.81 [95% CI, 1.03–22.42]). Bevacizumab was also found to significantly increase the risk of cardiac ischemia in patients with colorectal cancer (RR, 2.13; 95% CI, 1.11–4.06) compared with controls. This meta-analysis shows the use of bevacizumab was associated with an increased risk of developing ischemic heart disease in colorectal cancer patients receiving this drug. Our conclusions are limited by the available data. Further evaluations of high-quality RCTs are needed.
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影响因子：
3.8
作者：
Cella, David;Wang, Molin;Wagner, Lynne;Miller, Kathy
通讯作者：
Miller, Kathy
DOI：
10.1152/ajpheart.01277.2005
发表时间：
2006-09-01
影响因子：
4.8
作者：
Gonzalez-Pacheco, Francisco R.;Deudero, Juan J. P.;Caramelo, Carlos
通讯作者：
Caramelo, Carlos
影响因子：
45.3
作者：
Giantonio, Bruce J.;Catalano, Paul J.;Benson, Al B., III
通讯作者：
Benson, Al B., III
影响因子：
168.9
作者：
Escudier, Bernard;Pluzanska, Anna;Moore, Nicola
通讯作者：
Moore, Nicola
DOI：
10.1016/s0140-6736(11)60545-x
发表时间：
2011-05-28
期刊：
Lancet (London, England)
影响因子：
--
作者：
Herbst RS;Ansari R;Bustin F;Flynn P;Hart L;Otterson GA;Vlahovic G;Soh CH;O'Connor P;Hainsworth J
通讯作者：
Hainsworth J