在多发性骨髓瘤治疗选择中平衡心脏毒性结局的风险：伊沙唑米、来那度胺和地塞米松（IRd）与卡非佐米、来那度胺和地塞米松（KRd）的回顾性多中心评价

EJHaem Pub Date : 2025-04-28 DOI:10.1002/jha2.70038

Benjamin J. Lee, Michael Sayer, Ali A. Naqvi, Karen T. Mai, Pranav M. Patel, Lisa X. Lee, Aya F. Ozaki

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引用次数: 0

摘要

卡非佐米的使用与心血管毒性广泛相关；ixazomib（一种新型口服蛋白酶体抑制剂）的风险被低估，也没有大型的比较分析。方法：我们利用TriNetX平台进行了一项回顾性队列研究，比较了来那度胺、地塞米松和伊沙唑米（IRd）或卡非佐米（KRd）治疗的多发性骨髓瘤患者的毒性结局。结果每组478例患者进行倾向评分匹配后，新发心力衰竭发生率(HR 0.25；p & lt;0.001)和心律失常(HR 0.57；p = 0.014) 6个月时的总生存率显著低于IRd，而3年的总生存率相似（p = 0.50）。结论与KRd相比，IRd与心脏毒性风险显著降低相关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

Balancing the Risk of Cardiotoxicity Outcomes in Treatment Selection for Multiple Myeloma: A Retrospective Multicenter Evaluation of Ixazomib, Lenalidomide, and Dexamethasone (IRd) Versus Carfilzomib, Lenalidomide, and Dexamethasone (KRd)

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Introduction

Carfilzomib use has been extensively associated with cardiovascular toxicity; the risk with ixazomib, a novel oral proteasome inhibitor, is underreported and no large comparative analysis is available.

Methods

We conducted a retrospective cohort study utilizing the TriNetX platform to compare toxicity outcomes among multiple myeloma patients who received lenalidomide, dexamethasone, and ixazomib (IRd) or carfilzomib (KRd).

Results

After propensity-score-matching 478 patients from each cohort, the onset of new heart failure (HR 0.25; p < 0.001) and arrhythmias (HR 0.57; p = 0.014) at 6 months were significantly lower with IRd while overall survival at 3 years was similar (p = 0.50).

Conclusion

IRd is associated with a significantly lower risk of cardiac toxicities compared to KRd.

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EJHaem

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