■接受酪氨酸激酶抑制剂(TKIs)治疗的慢性粒细胞白血病(CML)患者通常会出现皮肤不良事件,如皮疹和瘙痒。在这项研究中,我们旨在比较伊马替尼和第二代TKI治疗的CML患者皮肤不良事件的风险.
■配对的审稿人独立获得了PubMed的研究,Embase,和Cochrane图书馆出版至2022年3月15日。搜索了以下术语:(白血病,骨髓性,慢性和BCR-ABL阳性),慢性粒细胞白血病,酪氨酸激酶抑制剂,TKI,伊马替尼,达沙替尼,尼洛替尼,博舒替尼,和拉多替尼。两名独立的审阅者筛选了结果,并选择了有关皮肤不良事件的文章。使用RevMan5.4和Cochrane协作工具进行荟萃分析和偏倚风险评估。
■本研究分析了11项涉及4502名患者的试验。使用第二代TKIs治疗的患者比使用伊马替尼治疗的患者更容易发生皮肤不良事件,相对风险(RR)为1.62(95%置信区间[CI],[1.25-2.09])。除达沙替尼(RR[95%CI],1.39[0.75-2.56]),第二代TKIs的不良事件风险高于伊马替尼,如下:尼洛替尼(2.11[1.53-2.90]),博舒替尼(1.41[1.07-1.86]),和拉多替尼(1.87[1.33-2.63])。皮疹是最常见的皮肤不良事件,在所有级别的21.6%的病例中观察到。其次是瘙痒(5.7%)和脱发(4.3%)。总之,我们的研究结果表明,第二代TKIs比伊马替尼更容易发生皮肤不良事件.因此,有效管理皮肤结果对于实现患者对药物的高依从性和TKIs的成功治疗是必要的。
UNASSIGNED: Patients with chronic myeloid leukemia (CML) treated with tyrosine kinase inhibitors (TKIs) often experience cutaneous adverse events, such as rashes and pruritus. In this study, we aimed to compare the risks of cutaneous adverse events between imatinib- and second-generation TKI-treated patients with CML.
UNASSIGNED: Paired reviewers independently obtained studies from PubMed, Embase, and Cochrane Library published until 15 March 2022. The following terms were searched: (Leukemia, Myelogenous, Chronic and BCR-ABL Positive), chronic myeloid leukemia, tyrosine kinase inhibitor, TKI, imatinib,
dasatinib, nilotinib, bosutinib, and radotinib. Two independent reviewers screened the results and selected articles on cutaneous adverse events. RevMan 5.4 and the Cochrane Collaboration tool were used to perform the meta-analysis and risk of bias assessment.
UNASSIGNED: Eleven trials involving 4502 patients were analyzed in this study. Patients treated with second-generation TKIs were significantly more likely to experience cutaneous adverse events than those treated with imatinib with a relative risk (RR) of 1.62 (95% confidence interval [CI], [1.25-2.09]). Except
dasatinib (RR [95% CI], 1.39 [0.75-2.56]), the risk of adverse events was more with second-generation TKIs than with imatinib as follows: nilotinib (2.11 [1.53-2.90]), bosutinib (1.41 [1.07-1.86]), and radotinib (1.87 [1.33-2.63]). Rash was the most common cutaneous adverse event that was observed in 21.6% of cases across all grades, followed by pruritus (5.7%) and alopecia (4.3%). In conclusion, our findings suggest that cutaneous adverse events occur more frequently with second-generation TKIs than with imatinib. Therefore, effective management of the cutaneous outcome is necessary to achieve high patient adherence to medication and successful treatment with TKIs.