Thromboembolic risk of carfilzomib or bortezomib in combination with lenalidomide and dexamethasone for newly diagnosed multiple myeloma: A comparative systematic review and meta-analysis Journal Article
| Authors: | Costa, B. A.; Costa, T. A.; Saravia, S. D.; Felix, N.; Tan, C. R.; Korde, N.; Richter, J. |
| Article Title: | Thromboembolic risk of carfilzomib or bortezomib in combination with lenalidomide and dexamethasone for newly diagnosed multiple myeloma: A comparative systematic review and meta-analysis |
| 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. © 2024 Wiley Periodicals LLC. |
| Keywords: | adult; controlled study; aged; middle aged; major clinical study; lenalidomide; prednisone; thalidomide; comparative study; antineoplastic agent; prospective study; quality control; progression free survival; bortezomib; multiple myeloma; erythropoietin; randomized controlled trial; antineoplastic combined chemotherapy protocols; cohort analysis; odds ratio; dexamethasone; melphalan; retrospective study; risk factor; risk assessment; confidence interval; t lymphocyte receptor; statistical analysis; systematic review; acetylsalicylic acid; multicenter study; thromboembolism; clopidogrel; warfarin; medline; upregulation; phase 3 clinical trial; cochrane library; oligopeptides; meta analysis; intercellular adhesion molecule 1; thrombocyte activation; carfilzomib; noradrenalin; venous thromboembolism; anticoagulant agent; rivaroxaban; embase; thrombomodulin; randomized controlled trial (topic); nitric oxide; oligopeptide; thrombocyte aggregation; thrombosis prevention; dabigatran; thrombogenicity; humans; human; male; female; article; ixazomib; daratumumab; isatuximab; preferred reporting items for systematic reviews and meta-analyses; prasugrel; cilostazol |
| Journal Title: | American Journal of Hematology |
| Volume: | 99 |
| Issue: | 6 |
| ISSN: | 0361-8609 |
| Publisher: | John Wiley & Sons, Inc. |
| Date Published: | 2024-06-01 |
| Start Page: | 1056 |
| End Page: | 1065 |
| Language: | English |
| DOI: | 10.1002/ajh.27288 |
| PUBMED: | 38488702 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | Article -- Source: Scopus |
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