Open AccessIncidence and Risk of Sorafenib‐Induced Hypertension: A Systematic Review and Meta‐Analysis
Author(s) -
Li Yan,
Li Shun,
Zhu Yaofeng,
Liang Xinyue,
Meng Hui,
Chen Jun,
Zhang Dongqing,
Guo Hu,
Shi Benkang
Publication year - 2014
Publication title -
the journal of clinical hypertension
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.909
H-Index - 67
eISSN - 1751-7176
pISSN - 1524-6175
DOI - 10.1111/jch.12273
Subject(s) - medicine , sorafenib , meta analysis , incidence (geometry) , confidence interval , renal cell carcinoma , relative risk , cochrane library , randomized controlled trial , gastroenterology , hepatocellular carcinoma , physics , optics
Hypertension is one of the major side effects of sorafenib, and reported incidences vary substantially among clinical trials. A systematic review was conducted using M edline, P ub M ed, E mbase, and the C ochrane L ibrary for all longitudinal studies to investigate the incidence and risk of hypertension events in cancer patients treated with sorafenib. A total of 14 randomized controlled trials and 39 prospective single‐arm trials involving 13,555 patients were selected for the meta‐analysis. The relative risk of all‐grade and high‐grade hypertension associated with sorafenib were 3.07 (95% confidence interval [ CI ], 2.05–4.60; P <.01) and 3.31 (95% CI, 2.21–4.95; P <.01), respectively. The overall incidence of sorafenib‐induced all‐grade and high‐grade hypertension were 19.1% (95% CI, 15.8%–22.4%) and 4.3% (95% CI, 3.0%–5.5%), respectively. A significantly higher incidence of hypertension was noted in patients with renal cell carcinoma ( RCC ) compared with those with non‐ RCC malignancies (all‐grade: 24.9% [95% CI, 19.7%–30.1%] vs 15.7% [95% CI, 12.1%–19.3%]; P <.05; high‐grade:8.6% [95% CI, 6.0%–11.2%] vs 1.8% [95% CI, 0.9%–2.6%]; P <.05). The trials with median progression‐free survival ( PFS ) longer than 5.3 months (mean PFS ) demonstrated a significantly higher incidence of high‐grade hypertension than trials with shorter PFS (6.3% [95% CI, 4.1%–8.5%] vs 2.6% [95% CI, 1.4%–3.8%]; P <.05). Findings of the meta‐analysis indicated a significantly high risk of sorafenib‐induced hypertension. Patients with RCC have a significantly higher incidence of hypertension and the occurrence of hypertension may be associated with improved prognosis.