Omar Abdel-Rahman1, Hesham ElHalawani2. 1. Clinical Oncology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt. Electronic address: omar.abdelrhman@med.asu.edu.eg. 2. Clinical Oncology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
Abstract
BACKGROUND: We performed a systematic review and meta-analysis of the risk of cardiovascular adverse events associated with ramucirumab. PATIENTS AND METHODS: Eligible studies included randomized phase II and III trials of patients with solid tumors on ramucirumab; describing events of hypertension, bleeding, arterial/venous thrombosis and congestive heart failure. RESULTS: Our search strategy yielded 160 potentially relevant citations from Pubmed/Medline, CENTRAL Cochrane registry and ASCO meeting library. After exclusion of ineligible studies, a total of 11 clinical trials were considered eligible for the meta-analysis. The RR of all-grade hypertension, bleeding, ATE, VTE and congestive heart failure were 2.83 (95% CI 2.43-3.29; p<0.0001), 1.98 (95% CI 1.77-2.21; p<0.0001); 0.97 (95% CI 0.62-1.52; p=0.91), 0.83 (95% CI 0.52-1.35; p=0.46), 1.36 (95% CI 0.77-2.4; p=0.28), respectively. CONCLUSIONS: Our meta-analysis has demonstrated that ramucirumab is associated with an increased risk of hypertension and bleeding. Clinicians should be aware of this risk and perform regular clinical monitoring.
BACKGROUND: We performed a systematic review and meta-analysis of the risk of cardiovascular adverse events associated with ramucirumab. PATIENTS AND METHODS: Eligible studies included randomized phase II and III trials of patients with solid tumors on ramucirumab; describing events of hypertension, bleeding, arterial/venous thrombosis and congestive heart failure. RESULTS: Our search strategy yielded 160 potentially relevant citations from Pubmed/Medline, CENTRAL Cochrane registry and ASCO meeting library. After exclusion of ineligible studies, a total of 11 clinical trials were considered eligible for the meta-analysis. The RR of all-grade hypertension, bleeding, ATE, VTE and congestive heart failure were 2.83 (95% CI 2.43-3.29; p<0.0001), 1.98 (95% CI 1.77-2.21; p<0.0001); 0.97 (95% CI 0.62-1.52; p=0.91), 0.83 (95% CI 0.52-1.35; p=0.46), 1.36 (95% CI 0.77-2.4; p=0.28), respectively. CONCLUSIONS: Our meta-analysis has demonstrated that ramucirumab is associated with an increased risk of hypertension and bleeding. Clinicians should be aware of this risk and perform regular clinical monitoring.