Renin-angiotensin-aldosterone system inhibitors and survival in patients with hypertension treated with immune checkpoint inhibitors.

Détails

Ressource 1Télécharger: 35065368_Renin–angiotensin–aldosterone system inhibitors and survival in patients with hypertension treated with immune checkpoint inhibitors.pdf (1195.49 [Ko])
Etat: Public
Version: Final published version
Licence: CC BY 4.0
ID Serval
serval:BIB_79B502336559
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
Renin-angiotensin-aldosterone system inhibitors and survival in patients with hypertension treated with immune checkpoint inhibitors.
Périodique
European journal of cancer
Auteur⸱e⸱s
Drobni Z.D., Michielin O., Quinaglia T., Zlotoff D.A., Zubiri L., Gilman H.K., Supraja S., Merkely B., Muller V., Sullivan R.J., Reynolds K.L., Pittet M.J., Jain R.K., Neilan T.G.
ISSN
1879-0852 (Electronic)
ISSN-L
0959-8049
Statut éditorial
Publié
Date de publication
03/2022
Peer-reviewed
Oui
Volume
163
Pages
108-118
Langue
anglais
Notes
Publication types: Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
Publication Status: ppublish
Résumé
Preclinical studies indicate that the concurrent use of inhibitors of the renin-angiotensin-aldosterone system (RAAS) may improve outcomes in broad groups of patients with cancer. There are limited data on the association between the use of RAAS inhibitors and outcomes among patients treated with immune checkpoint inhibitors (ICIs).
We performed a retrospective study of all patients treated with an ICI in a single academic network. Of 10,903 patients, 5910 were on any anti-hypertensive medication. Of those on anti-hypertensive therapy, 3426 were prescribed a RAAS inhibitor during ICI treatment, and 2484 were prescribed other anti-hypertensive medications. The primary outcome was overall survival in the entire cohort and in sub-groups by cancer types.
Thoracic cancer (34%) and melanoma (16%) were the most common types of cancer. Those prescribed a RAAS inhibitor were older, more frequently male, and had more cardiovascular risk factors. In a Cox proportional hazard model, the concurrent use of RAAS inhibitors was associated with better overall survival (hazard ratio (HR):0.92, [95% Confidence Interval (CI):0.85-0.99], P = .032). Patients with gastrointestinal (HR:0.82, [95% CI: 0.67-1.01], P = .057) and genitourinary cancer (HR:0.81, [95% CI:0.64-1.01], P = .067) had a non-statistically significant better overall survival.
In this large retrospective study, patients with hypertension who were concomitantly taking a RAAS inhibitor during ICI therapy had better overall survival. This benefit was primarily noted among patients with gastrointestinal and genitourinary cancers. Prospective randomized trials are warranted to further evaluate and specify the benefit of RAAS inhibitors in patients with cancer who receive ICI therapy.
Mots-clé
Angiotensin Receptor Antagonists/pharmacology, Angiotensin Receptor Antagonists/therapeutic use, Angiotensin-Converting Enzyme Inhibitors/therapeutic use, Antihypertensive Agents/pharmacology, Antihypertensive Agents/therapeutic use, Humans, Hypertension/chemically induced, Hypertension/drug therapy, Immune Checkpoint Inhibitors/adverse effects, Male, Prospective Studies, Renin-Angiotensin System, Retrospective Studies, ACEI, ARB, Immune checkpoint inhibitors, Immune therapy, Renin–angiotensin–aldosterone system blocker
Pubmed
Web of science
Open Access
Oui
Création de la notice
31/01/2022 10:50
Dernière modification de la notice
19/12/2023 7:22
Données d'usage