Abstract
Original language | English |
---|---|
Pages (from-to) | 63-74 |
Number of pages | 12 |
Journal | Journal of Internal Medicine |
Volume | 286 |
Issue number | 1 |
DOIs | |
Publication status | Published - 1 Jul 2019 |
Keywords
- adverse events
- blood pressure monitoring
- cardiovascular toxicity
- carfilzomib
- clinical assessment
- multiple myeloma
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In: Journal of Internal Medicine, Vol. 286, No. 1, 01.07.2019, p. 63-74.
Research output: Contribution to journal › Article › Academic › peer-review
TY - JOUR
T1 - Prevention, monitoring and treatment of cardiovascular adverse events in myeloma patients receiving carfilzomib A consensus paper by the European Myeloma Network and the Italian Society of Arterial Hypertension
AU - Bringhen, S.
AU - Milan, A.
AU - D'Agostino, M.
AU - Ferri, C.
AU - Wäsch, R.
AU - Gay, F.
AU - Larocca, A.
AU - Offidani, M.
AU - Zweegman, S.
AU - Terpos, E.
AU - Goldschmidt, H.
AU - Cavo, M.
AU - Ludwig, H.
AU - Driessen, C.
AU - Auner, H. W.
AU - Caers, J.
AU - Gramatzki, M.
AU - Dimopoulos, M. A.
AU - Boccadoro, M.
AU - Einsele, H.
AU - Sonneveld, P.
AU - Engelhardt, M.
N1 - Funding Information: From the 1Myeloma Unit, Division of Hematology, University of Torino, Azienda Ospedaliero-Universitaria Citta della Salute e della Scienza di Torino; 2Department of Medical Sciences, Internal Medicine and Hypertension Division, AOU Citta della Salute e della Scienza di Torino, Rete Oncologica Piemontese, University of Torino, Torino, Italy; 3University of L’Aquila, MeSVA Department - San Salvatore Hospital, Division of Internal Medicine & Nephrology, Coppito, Italy; 4Department of Medicine I, Hematology, Oncology & Stem Cell Transplantation, Medical Center – University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany; 5Clinica di Ematologia, AOU Ospedali Riuniti di Ancona, Ancona, Italy; 6Amsterdam UMC, Vrije Universiteit Amsterdam, VU University Medical Center, Department of Hematology, Cancer Center Amsterdam, Amsterdam, the Netherlands; 7Department of Clinical Therapeutics, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece; 8University Clinic Heidelberg, Internal Medicine V and National Center for Tumor Diseases (NCT), Heidelberg, Germany; 9‘Seragnoli’ Institute of Hematology and Medical Oncology, University of Bologna, Bologna, Italy; 101. Medical Department and Oncology, Wilhelminenspital Wien, Vienna, Austria; 11Department of Oncology and Hematology, Kantonsspital St. Gallen, St. Gallen, Switzerland; 12Faculty of Medicine, Department of Medicine, Imperial College London, London, UK; 13Department of Hematology, Domaine University Liege, Liege, Belgium;14Division of Stem Cell Transplantation and Immunotherapy, University of Kiel, Kiel; 15Department of Internal Medicine II, University Hospital Wu€rzburg, Wu€rzburg, Germany; and 16Department of Hematology, Erasmus Medical Center, Rotterdam, the Netherlands Funding Information: Sara Bringhen has received honoraria from Bristol-Myers Squibb, Celgene, Amgen and Jans-sen; has served on the advisory boards for Amgen and Janssen; and has undertaken consultancy for Takeda. Alberto Milan has received speaker and/or consulting honoraria from Amgen and Boehringer. Francesca Gay has received honoraria from Takeda, Amgen, Celgene, Janssen, and Bristol-Myers Squibb; has served on the advisory boards for Amgen, Bristol-Myers Squibb, Celgene, Janssen, Roche, and Takeda. Alessandra Larocca has received honoraria from Amgen, Bristol-Myers Squibb, Celgene, and Janssen; has served on the advisory boards for Bristol-Myers Squibb, Celgene, Janssen, and Takeda. Massimo Offidani has received honoraria from and served on the advisory boards for Celgene, Janssen, Takeda, Amgen, and Bristol-Myers Squibb. Evangelos Terpos has received honoraria from Amgen, Cel-gene, Genesis, Janssen, Novartis, Takeda, Abb-Vie, Bristol-Myers Squibb, and GSK; research funding from Celgene, Janssen, and Amgen; has participated in DMC for Celgene and in SC for Amgen, Takeda and Janssen. Hartmut Gold-schmidt has received research support (Institutions) from Amgen, Bristol-Myers Squibb, Celgene, Chugai, Janssen, Sanofi, Mundipharma, Takeda, and Novartis; honoraria (Speakers’ Bureaus) from Celgene, Janssen, Novartis, Chu-gai, Bristol-Myers Squibb and ArtTempi; has served on the advisory boards (Institutions) for Adaptive Biotechnology, Amgen, Bristol-Myers Squibb, Celgene, Janssen, Sanofi, and Takeda. Michele Cavo has received honoraria from Jans-sen, Amgen, Bristol-Myers Squibb, and Celgene. Holger W. Auner has received research support from Amgen; has served on the advisory boards for and received honoraria from Amgen, Takeda, Karyopharm, Chugai, and Novartis. Jo Caers has served on the advisory boards for and received honoraria from Amgen, Celgene, and Janssen; has received research funding from Celgene. Meletios A. Dimopoulos has received honoraria from consultancy and advisory boards from Cel-gene, Janssen, Amgen, Takeda, and Bristol-Myers Squibb. Mario Boccadoro has received honoraria from Sanofi, Celgene, Amgen, Janssen, Novartis, AbbVie, and Bristol-Myers Squibb; has received research funding from Celgene, Janssen, Amgen, Bristol-Myers Squibb, Mundipharma, Novartis, and Sanofi. Hermann Einsele has served on the advisory boards for, and received honoraria and research support from Janssen and Celgene, and he is a member of their speaker’s bureaus; he has received honoraria from Amgen and Novartis and he is a member of their speaker’s bureaus. Pieter Sonneveld has served on the advisory boards for and received honoraria from Amgen, Celgene, Janssen, Karyo-pharm and Takeda-Millennium; has received research support from Amgen, Celgene, Janssen, Takeda-Millennium, and SkylineDx. Monika Engelhardt has received honoraria and research support from Bristol-Myers Squibb, Celgene, Amgen and Janssen; has served on the advisory boards for Amgen and Janssen. The remaining authors have no relevant conflicts of interest. Funding Information: Holger W. Auner acknowledges the support of the Imperial College London National Institute of Health Research-Biomedical Research Centre (NIHR-BRC) and the Imperial College London Cancer Research UK Centre. Publisher Copyright: © 2019 The Association for the Publication of the Journal of Internal Medicine Copyright: Copyright 2019 Elsevier B.V., All rights reserved.
PY - 2019/7/1
Y1 - 2019/7/1
N2 - Background: The novel proteasome inhibitor carfilzomib alone or in combination with other agents is already one of the standard therapies for relapsed and/or refractory multiple myeloma (MM) patients and produces impressive response rates in newly diagnosed MM as well. However, carfilzomib-related cardiovascular adverse events (CVAEs) – including hypertension (all grades: 12.2%; grade ≥3: 4.3%), heart failure (all grades: 4.1%; grade ≥3: 2.5%) and ischemic heart disease (all grades: 1.8%; grade ≥3: 0.8%) – may lead to treatment suspensions. At present, there are neither prospective studies nor expert consensus on the prevention, monitoring and treatment of CVAEs in myeloma patients treated with carfilzomib. Methods: An expert panel of the European Myeloma Network in collaboration with the Italian Society of Arterial Hypertension and with the endorsement of the European Hematology Association aimed to provide recommendations to support health professionals in selecting the best management strategies for patients, considering the impact on outcome and the risk-benefit ratio of diagnostic and therapeutic tools, thereby achieving myeloma response with novel combination approaches whilst preventing CVAEs. Results: Patients scheduled to receive carfilzomib need a careful cardiovascular evaluation before treatment and an accurate follow-up during treatment. Conclusions: A detailed clinical assessment before starting carfilzomib treatment is essential to identify patients at risk for CVAEs, and accurate monitoring of blood pressure and of early signs and symptoms suggestive of cardiac dysfunction remains pivotal to safely administer carfilzomib without treatment interruptions or dose reductions.
AB - Background: The novel proteasome inhibitor carfilzomib alone or in combination with other agents is already one of the standard therapies for relapsed and/or refractory multiple myeloma (MM) patients and produces impressive response rates in newly diagnosed MM as well. However, carfilzomib-related cardiovascular adverse events (CVAEs) – including hypertension (all grades: 12.2%; grade ≥3: 4.3%), heart failure (all grades: 4.1%; grade ≥3: 2.5%) and ischemic heart disease (all grades: 1.8%; grade ≥3: 0.8%) – may lead to treatment suspensions. At present, there are neither prospective studies nor expert consensus on the prevention, monitoring and treatment of CVAEs in myeloma patients treated with carfilzomib. Methods: An expert panel of the European Myeloma Network in collaboration with the Italian Society of Arterial Hypertension and with the endorsement of the European Hematology Association aimed to provide recommendations to support health professionals in selecting the best management strategies for patients, considering the impact on outcome and the risk-benefit ratio of diagnostic and therapeutic tools, thereby achieving myeloma response with novel combination approaches whilst preventing CVAEs. Results: Patients scheduled to receive carfilzomib need a careful cardiovascular evaluation before treatment and an accurate follow-up during treatment. Conclusions: A detailed clinical assessment before starting carfilzomib treatment is essential to identify patients at risk for CVAEs, and accurate monitoring of blood pressure and of early signs and symptoms suggestive of cardiac dysfunction remains pivotal to safely administer carfilzomib without treatment interruptions or dose reductions.
KW - adverse events
KW - blood pressure monitoring
KW - cardiovascular toxicity
KW - carfilzomib
KW - clinical assessment
KW - multiple myeloma
UR - http://www.scopus.com/inward/record.url?scp=85064094802&partnerID=8YFLogxK
U2 - https://doi.org/10.1111/joim.12882
DO - https://doi.org/10.1111/joim.12882
M3 - Article
C2 - 30725503
SN - 0954-6820
VL - 286
SP - 63
EP - 74
JO - Journal of Internal Medicine
JF - Journal of Internal Medicine
IS - 1
ER -