来那度胺
Carfilzomib公司
硼替佐米
多发性骨髓瘤
地塞米松
医学
肿瘤科
内科学
荟萃分析
沙利度胺
作者
Bruno Almeida Costa,Thomaz Alexandre Costa,Sara Diaz Saravia,Nicole Félix,Carlyn Tan,Neha Korde,Joshua Richter
摘要
Abstract Thrombosis represents a frequent and potentially severe complication in individuals diagnosed with multiple myeloma (MM). These events can be driven by both the disease as well as the therapies themselves. Overall, available evidence is inconclusive about the differential thrombogenicity of carfilzomib/lenalidomide/dexamethasone (KRd) and bortezomib/lenalidomide/dexamethasone (VRd). This meta‐analysis compares the risk for venous thromboembolism (VTE; including deep venous thrombosis and pulmonary embolism) and arterial thromboembolism (ATE; including myocardial infarction and ischemic stroke) with KRd versus VRd as primary therapy for newly diagnosed MM (NDMM). Out of 510 studies identified after deduplication, one randomized controlled trial and five retrospective cohort studies were included. We analyzed 2304 patients (VRd: 1380; KRd: 924) for VTE events and 2179 patients (VRd: 1316; KRd: 863) for ATE events. Lower rates of VTE were observed in the VRd group when compared with the KRd group (6.16% vs. 8.87%; odds ratio [OR], 0.53; 95% confidence interval [CI], 0.32–0.88; p = .01). Both treatment groups exhibited minimal ATE incidence, with no significant difference between them (0.91% vs. 1.16%; OR, 1.01; 95% CI, 0.24–4.20; p = .99). In view of potential biases from retrospective studies, heterogeneity of baseline population characteristics, and limited access to patient‐level data (e.g., VTE risk stratification and type of thromboprophylaxis regimen used) inherent to this meta‐analysis, additional research is warranted to further validate our findings and refine strategies for thrombosis prevention in MM.
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