Cardiovascular risk profile of patients with peripheral arterial occlusive disease during nilotinib therapy

• Published in: Targeted oncology Vol. 11; no. 4; pp. 549 - 552
• Main Authors: Bondon-Guitton, E., Combret, S., Pérault-Pochat, M. C., Stève-Dumont, M., Bagheri, H., Huguet, F., Despas, F., Pathak, A., Montastruc, J. L.
• Format: Journal Article
• Language: English
• Published: Cham Springer International Publishing 01-08-2016; Springer Nature B.V
• Subjects: Arterial Occlusive Diseases - chemically induced; Biomedicine; Cardiovascular Diseases - etiology; Female; Humans; Male; Medicine; Medicine & Public Health; Oncology; Pyrimidines - administration & dosage; Pyrimidines - adverse effects; Pyrimidines - pharmacology; Risk Factors; Short Communication; Nilotinib; Dasatinib; Imatinib; Cardiovascular Risk Factor; Dabigatran
• ISSN: 1776-2596; 1776-260X
• DOI: 10.1007/s11523-016-0417-x

Background
Over the past few years, data have suggested that severe peripheral arterial occlusive disease (PAOD) is associated with nilotinib exposure. However, the characteristics of this adverse drug reaction are poorly described since its frequency is low. As far as we know, no study using a spontaneous adverse drug reactions reporting system was performed to describe the characteristics of cases of PAOD related to nilotinib.
Objective
We performed a study to describe the cardiovascular risk profile of cases of PAOD in patients treated with nilotinib spontaneously reported to the French Pharmacovigilance Database (FPVD).
Patients/Methods
We selected all cases of “vascular disorders,” as the System Organ Class in MedDRA®, in which nilotinib was “suspected” and recorded in the French Pharmacovigilance Database between 2007 and 21 October 2014. We then identified cases of PAOD with a Low Level Term and through a detailed summary of the clinical description.
Results
We identified 25 cases of POAD. Most of the patients were older than 60 years (84 %) or had another cardiovascular risk factor such as hypercholesterolemia, arterial hypertension, overweight/obesity, smoking, or diabetes mellitus (72 %). Females (13 cases) and males (12 cases) were equally represented, but the presence of cardiovascular risk factors was more frequent in females than in males. The mean time from initiation of nilotinib to PAOD onset was 24 months and was significantly longer in patients aged less than 60 years compared with those aged over 60 years (33.8 ± 24.6 months vs. 22.6 ± 17.5 months,
p
 = 0.002). Pre-existing cardiovascular risk factors, especially diabetes mellitus, also seem to accelerate its occurrence.
Conclusions
The FPVD is a useful tool in describing the cardiovascular risk profile of patients with PAOD during nilotinib exposure. Physicians have to be particularly vigilant in patients older than 60 years of age; in patients younger than 60 years of age, long-term surveillance has to be maintained.