Nilotinib Associated With Treatment-induced T2DM and Hyperlipidemia

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This study suggest that nilotinib is associated with higher rates of treatment-induced T2DM and hyperlipidemia compared with dasatinib.
This study suggest that nilotinib is associated with higher rates of treatment-induced T2DM and hyperlipidemia compared with dasatinib.
The following article features coverage from the 2017 Hematology/Oncology Pharmacy Association (HOPA) Annual Conference in Anaheim, California. Click here to read more of Cancer Therapy Advisor's conference coverage.

Nilotinib is more likely to induce type II diabetes mellitus (T2DM) and hyperlipidemia compared with dasatinib among patients with chronic myeloid leukemia (CML), according to a poster presented at the 2017 Hematology/Oncology Pharmacy Association (HOPA) Annual Conference.1

Previous studies suggested that tyrosine kinase inhibitor (TKI) therapy can induce metabolic changes such as T2DM. The purpose of this study was to determine the incidence and risk of T2DM and hyperlipidemia among patients taking first- or second-line dasatinib or nilotinib.

This retrospective cohort study included data from 2006 to 2014 of 2650 patients with CML receiving dasatinib or nilotinib. Two cohorts were created: cohort 1 was evaluated for T2DM (2004 patients) and cohort 2 was evaluated for hyperlipidemia (1280 patients). Patients with either condition were excluded from the respective cohort.

In the study, 37% of patients received nilotinib, and 54% of patients were on their first-line of treatment. The median follow-up was 216 and 213 days with dasatinib and 245 and 206 days with nilotinib in cohorts 1 and 2, respectively.

The incidence of T2DM was 17.6 per 1000 person years (95% CI, 11.1-26.4 per 1000 person years) in the dasatinib group compared with 40.4 per 1000 person years (95% CI, 27.6-57.0 per 1000 person years) in the nilotinib group.

The risk of developing T2DM was significantly lower among patients receiving dasatinib compared with nilotinib (hazard ratio [HR], 0.36; 95% CI, 0.21-0.63; P = .0004).

The incidence of hyperlipidemia was also higher in the nilotinib group (74.6 per 1000 person years; 95% CI, 50.7-105.9) compared with the dasatinib group (46.4 per 1000 person years; 95% CI, 33.0-63.5), resulting in a significantly lower risk for developing hyperlipidemia among patients taking dasatinib (HR, 0.57; 95% CI, 0.35-0.93; P = .025).

RELATED: TKIs Linked to Pulmonary Hypertension in CML

The results of this study suggest that nilotinib is associated with higher rates of treatment-induced T2DM and hyperlipidemia compared with dasatinib. According to the authors, “understanding the impact of metabolic outcomes associated with TKI therapy can help inform healthcare professionals when making treatment decisions.”

Read more of Cancer Therapy Advisor's coverage of the 2017 Hematology/Oncology Pharmacy Association (HOPA) Annual Conference by visiting the conference page.

Reference

  1. Franklin M, Burns L, Perez S, Yerragolam D, Makenbaeva D. Real-world evaluation of new-onset type II diabetes mellitus and hyperlipidemia in patients prescribed dasatinib or nilotinib for chronic myelogenous leukemia (CML). Poster presented at: 13th Hematology/Oncology Pharmacy Association Annual Conference; March 29-April 1, 2017; Anaheim, CA.

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