Document Detail


Blood pressure control in patients receiving bevacizumab in an outpatient cancer center.
MedLine Citation:
PMID:  20817652     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: Hypertension is a common adverse effect of vascular endothelial growth factor (VEGF) signaling inhibitors, such as bevacizumab, with an incidence upwards of 35%. The management of bevacizumab-induced hypertension is important in order to avoid dose interruption/discontinuation and/or end organ damage. The efficacy of antihypertensive medications for this cause of hypertension has not been demonstrated. This study seeks to determine if antihypertensives are effective in treating anti-VEGF-induced hypertension from bevacizumab and determine which classes of antihypertensive agents are effective.
METHODS: A retrospective review of all patients who received bevacizumab between January 2007 and September 2009 at two medical centers was conducted. Patients were included if they experienced new onset or exacerbation of preexisting hypertension, during bevacizumab treatment. Efficacy of antihypertensives was determined by recording a 28-day change in systolic blood pressure from the initiation or dose increase of individual antihypertensive medications. Secondary endpoints included an efficacy analysis of antihypertensive classes.
RESULTS: Five-hundred thirteen patients were identified as receiving bevacizumab during the indicated time period. Fifty-seven patients met the full inclusion/exclusion criteria for analysis. The average systolic blood pressure declined by 23  mm Hg with 4 weeks of treatment (p < 0.0001). Each class had a statistically significant decline in systolic blood pressure of 15.5-57 mm Hg with the exception of diuretics and a group of miscellaneous antihypertensives.
CONCLUSIONS: This is the first data that demonstrates individual classes of antihypertensives are effective in bevacizumab-induced hypertension. Most antihypertensives were effective in reducing blood pressure, with the exception of diuretics and miscellaneous antihypertensives, which may be due to a limited sample size.
Authors:
Sal Bottiglieri; Benyam Muluneh; Stephanie Sutphin; Lew Iacovelli; Val Adams
Publication Detail:
Type:  Comparative Study; Journal Article; Multicenter Study     Date:  2010-09-03
Journal Detail:
Title:  Journal of oncology pharmacy practice : official publication of the International Society of Oncology Pharmacy Practitioners     Volume:  17     ISSN:  1477-092X     ISO Abbreviation:  J Oncol Pharm Pract     Publication Date:  2011 Dec 
Date Detail:
Created Date:  2011-12-01     Completed Date:  2012-04-17     Revised Date:  2013-05-27    
Medline Journal Info:
Nlm Unique ID:  9511372     Medline TA:  J Oncol Pharm Pract     Country:  England    
Other Details:
Languages:  eng     Pagination:  333-8     Citation Subset:  IM    
Affiliation:
UKHealthCare, University of Kentucky, Department of Pharmacy, Lexington, KY 40536, USA. sal.pharm.d@gmail.com
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MeSH Terms
Descriptor/Qualifier:
Antibodies, Monoclonal, Humanized / pharmacology,  therapeutic use*
Blood Pressure / drug effects*,  physiology
Female
Humans
Hypertension / drug therapy,  epidemiology*,  physiopathology
Male
Middle Aged
Neoplasms / drug therapy*,  epidemiology*,  physiopathology
Outpatient Clinics, Hospital*
Retrospective Studies
Chemical
Reg. No./Substance:
0/Antibodies, Monoclonal, Humanized; 2S9ZZM9Q9V/bevacizumab

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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