Core Concepts
Nilotinib in CML patients increases the risk of metabolic syndrome and cardiovascular diseases.
Abstract
TOPLINE:
Patients on nilotinib have a higher risk of diabetes, hyperlipidemia, and cardiovascular disease compared to other tyrosine kinase inhibitors for CML.
METHODOLOGY:
Tyrosine kinase inhibitors pose risks for metabolic syndrome and CVD in CML patients.
Unclear which TKI - imatinib, nilotinib, or dasatinib - carries the highest risk.
Taiwanese study reviewed databases of 1538 CML patients on TKIs for new-onset metabolic syndrome and CVD.
TAKEAWAY:
Nilotinib patients had higher incidence rates of diabetes and hyperlipidemia compared to imatinib and dasatinib.
Nilotinib was a significant risk factor for post-TKI diabetes and hyperlipidemia.
Nilotinib patients more likely to develop CVD than imatinib patients.
IN PRACTICE:
Study highlights the association between nilotinib, metabolic syndrome, and CVD.
Suggests avoiding nilotinib in CML patients with poorly controlled diabetes and hyperlipidemia.
SOURCE:
Study led by Cih-En Huang published in The Oncologist.
LIMITATIONS:
Retrospective study with a small number of cases may affect results.
DISCLOSURES:
Supported by Chang Gung Medical Foundation, Taiwan. No conflicts of interest.
Stats
"The risk for diabetes, hyperlipidemia, and cardiovascular disease is higher in patients receiving nilotinib (Tasigna) vs other tyrosine kinase inhibitors for chronic myeloid leukemia (CML)."
"The incidence rate ratios (IRR) of post-TKI diabetes were highest among patients treated with nilotinib vs imatinib and dasatinib (IRR, 3.15 for nilotinib vs imatinib; IRR, 4.97 nilotinib vs dasatinib)."
Quotes
"The present study represents the first report demonstrating a significant association between nilotinib, metabolic syndrome, and CVDs."
"To reduce the risk of CVD, it may be important to avoid nilotinib in patients with CML who have poorly controlled diabetes and hyperlipidemia."