In a nutshell
The study analyzed multiple clinical trials for assessing the effects of carfilzomib (Kyprolis) based treatment on kidney toxicity in patients with multiple myeloma (MM). The main finding was that kidney toxicity was an important side effect of carfilzomib based therapy.
Carfilzomib is largely used to treat MM. It is a targeted therapy. It targets molecules called proteasomes and stops cancer cell growth. It improved survival in patients with MM compared to bortezomib (Velcade). However, some trials reported kidney toxicity and acute kidney injury (AKI) upon carfilzomib use. Multiple physiological factors can also cause kidney damage in MM. Therefore, it is important to evaluate the link between carfilzomib and kidney toxicity in MM.
Methods & findings
This study analyzed 4 clinical trials with a total of 2954 patients with MM. Each of them compared kidney toxicity upon carfilzomib and control (non-carfilzomib) based therapy. Carfilzomib treatment was given for 16.3 to 88 weeks on average. The average duration for control treatment was 10.7 to 57 weeks in control groups.
The risks of developing all types of kidney toxicity under carfilzomib therapy were 21.3% across trials. The risk of severe kidney side effects was 8.3%. The most common side effect was AKI. AKI prevents the kidney’s capacity of filtering wastes from the blood.
Patients on carfilzomib had 79% higher risks of developing all types of kidney toxicities compared to control. Carfilzomib group was also 2.29 times more likely to have severe toxicities compared to controls.
Drug doses and duration of infusion and treatment did not impact the risk of kidney toxicities.
The bottom line
The authors concluded that carfilzomib-based treatment is related to high risks of kidney toxicity in patients with MM. Risks and benefits of this therapy should be carefully assessed before giving to such patients.
Published By :
Annals of Hematology
May 08, 2020
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