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2017 ; 8
(31
): 51492-51506
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Bevacizumab significantly increases the risks of hypertension and proteinuria in
cancer patients: A systematic review and comprehensive meta-analysis
#MMPMID28881662
Zhao T
; Wang X
; Xu T
; Xu X
; Liu Z
Oncotarget
2017[Aug]; 8
(31
): 51492-51506
PMID28881662
show ga
Published data regarding the overall risks and incidence of hypertension and
proteinuria associated with bevacizumab were still unclear. To quantify the
precise risks and incidence, we performed this comprehensive meta-analysis of 72
published clinical trials including 21902 cases and 20608 controls. The overall
incidence, risk ratios (RRs), and 95% confidence intervals (95% CIs) were
calculated using a fixed or random-effect model based on the heterogeneity. The
incidence of all-grade and high-grade hypertension were 25.3% (95% CI:
21.5%-29.5%) and 8.2% (95% CI: 7%-9.8%) for patients treated with bevacizumab.
And the incidence of all-grade and high-grade proteinuria were 18% (95% CI:
11.7%-26.6%) and 2.4% (95% CI: 1.8%-3.2%), respectively. Compared with controls,
bevacizumab significantly increased the risks of all-grade (RR: 3.595, 95% CI:
2.952-4.378) and high-grade hypertension (RR: 5.173, 95% CI: 4.188-6.390).
Obviously increased risks of all-grade (RR: 3.369, 95% CI: 2.492-4.556) and
high-grade proteinuria (RR: 5.494, 95% CI: 3.991-7.564) were also observed. In
the subgroup analysis, the risks of hypertension and proteinuria may
significantly vary with bevacizumab dosage, cancer types and concomitant drugs.
Whereas, no obvious difference were discovered when stratified based on phase of
trials, age of patients, treatment line and duration. So, close monitor and
effective management were highly recommended for the safe use of bevacizumab.