PDF(Pubmed)
Abstract：
This study aims to figure out the worldwide prevalence of anticancer therapy-associated acute kidney injury (AKI) and tubulointerstitial nephritis (TIN) and the relative risk of each cancer drug. We conducted an analysis of VigiBase, the World Health Organization pharmacovigilance database, 1967-2023 via disproportionate Bayesian reporting method. We further categorized the anticancer drugs into four groups: cytotoxic therapy, hormone therapy, immunotherapy, and targeted therapy. Reporting odds ratio (ROR) and information component (IC) compares observed and expected values to investigate the associations of each category of anticancer drugs with AKI and TIN. We identified 32,722 and 2056 reports (male, n = 17,829 and 1,293) of anticancer therapy-associated AKI and TIN, respectively, among 4,592,036 reports of all-drug caused AKI and TIN. There has been a significant increase in reports since 2010, primarily due to increased reports of targeted therapy and immunotherapy. Immunotherapy exhibited a significant association with both AKI (ROR: 8.92; IC0.25: 3.06) and TIN (21.74; 4.24), followed by cytotoxic therapy (7.14; 2.68), targeted therapy (5.83; 2.40), and hormone therapy (2.59; 1.24) for AKI, and by cytotoxic therapy (2.60; 1.21) and targeted therapy (1.54; 0.61) for TIN. AKI and TIN were more prevalent among individuals under 45 years of age, with a female preponderance for AKI and males for TIN. These events were reported in close temporal relationship after initiation of the respective drug (16.53 days for AKI and 27.97 days for TIN), and exhibited a high fatality rate, with 23.6% for AKI and 16.3% for TIN. These findings underscore that kidney-related adverse drug reactions are of prognostic significance and strategies to mitigate such side effects are required to optimize anticancer therapy.
摘要：
这项研究旨在了解抗癌治疗相关的急性肾损伤（AKI）和肾小管间质性肾炎（TIN）的全球患病率以及每种癌症药物的相对风险。我们对Vigibase进行了分析，世界卫生组织药物警戒数据库，1967-2023年通过不成比例的贝叶斯报告方法。我们进一步将抗癌药物分为四组：细胞毒性疗法，激素治疗,免疫疗法，和靶向治疗。报告比值比（ROR）和信息成分（IC）比较了观察到的和预期的值，以研究每种抗癌药物与AKI和TIN的关联。我们确定了32,722和2056例报告(男性，n=17,829和1,293）的抗癌治疗相关的AKI和TIN，分别,在4,592,036例全药物引起的AKI和TIN报告中。自2010年以来，报告显着增加，主要是由于靶向治疗和免疫疗法的报告增加。免疫疗法与AKI（ROR：8.92;IC0.25：3.06）和TIN（21.74;4.24）均有显着关联，其次是细胞毒性治疗（7.14;2.68），靶向治疗（5.83；2.40），和激素治疗（2.59;1.24）的AKI，通过TIN的细胞毒性治疗(2.60;1.21)和靶向治疗(1.54;0.61)。AKI和TIN在45岁以下的人群中更为普遍，女性占AKI的优势，男性占TIN的优势。这些事件在各自药物开始后有密切的时间关系报告（AKI16.53天，TIN27.97天），并表现出很高的死亡率，AKI占23.6%，TIN占16.3%。这些发现强调了与肾脏相关的药物不良反应具有预后意义，并且需要减轻此类副作用的策略来优化抗癌治疗。
