title: Low impact of cardiovascular adverse events on anagrelide treatment discontinuation in a cohort of 232 patients with essential thrombocythemia.
abstract: This retrospective study of the thrombocythemia Italian registry (RIT) documented that 71 (30.6%) out of 232 ET patients experienced 88 cardiovascular adverse events (CV-AEs) during anagrelide treatment (522 pt-y). The rate of CV-AEs was: 24.1% for palpitations, 4.3% for angina, 3.5% for arterial hypertension, 3.0% for congestive heart failure, 1.8% for arrhythmia, 0.9% for AMI, 0.4% for pericardial effusion. CV-AEs led to treatment discontinuation in nine (3.9%) patients, while in the remaining cases they were managed by pharmacological intervention and/or patient life style improvement. CV-AEs had no relationship with patient characteristics (including older age). A significant relationship was found only with a higher anagrelide induction dose. In the absence of any agreed protocol, a cardiovascular instrumental evaluation (CV-IE) was performed in 102 (44%) patients before commencement of anagrelide (with higher rate after the anagrelide/Xagrid EMA approval of 2004), and in 84 (36%) patients during treatment. Patients with and without CV-IEs, who resulted completely balanced for all their characteristics, did not significantly differ in the occurrence of CV-AEs. In conclusion, this study on ET patients treated with anagrelide shows that CV-AEs, equally distributed in younger and older subjects, were mostly mild and easily manageable, allowing safe treatment continuation in the majority of cases. Moreover, routinely performing a CV-IE did not appear to anticipate the occurrence of CV-AEs.
authors.affiliation: Hematology Institute L e A Seragnoli, University Hospital, Bologna, Italy. luigi.gugliotta@unibo.it
authors.forename: Luigi
authors.initials: L
authors.lastname: Gugliotta
authors.forename: Alessia
authors.initials: A
authors.lastname: Tieghi
authors.forename: Giovanni
authors.initials: G
authors.lastname: Tortorella
authors.forename: Potito Rosario
authors.initials: PR
authors.lastname: Scalzulli
authors.forename: Rosanna
authors.initials: R
authors.lastname: Ciancia
authors.forename: Monia
authors.initials: M
authors.lastname: Lunghi
authors.forename: Emma
authors.initials: E
authors.lastname: Cacciola
authors.forename: Rossella
authors.initials: R
authors.lastname: Cacciola
authors.forename: Anna
authors.initials: A
authors.lastname: Candoni
authors.forename: Monica
authors.initials: M
authors.lastname: Crugnola
authors.forename: Katia
authors.initials: K
authors.lastname: Codeluppi
authors.forename: Emilio
authors.initials: E
authors.lastname: Usala
authors.forename: Giorgina
authors.initials: G
authors.lastname: Specchia
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Martinelli
authors.forename: Fausto
authors.initials: F
authors.lastname: Palmieri
authors.forename: Ivana
authors.initials: I
authors.lastname: Pierri
authors.forename: Anna Marina
authors.initials: AM
authors.lastname: Liberati
authors.forename: Alessandra
authors.initials: A
authors.lastname: Iurlo
authors.forename: Alberto
authors.initials: A
authors.lastname: Grossi
authors.forename: Alessandro M
authors.initials: AM
authors.lastname: Vannucchi
authors.forename: Nicola
authors.initials: N
authors.lastname: Vianelli
authors.forename: Maria Gabriella
authors.initials: MG
authors.lastname: Mazzucconi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002318:Cardiovascular Diseases / Q000139:chemically induced / Q000453:epidemiology*; D002648:Child; D015331:Cohort Studies; D064420:Drug-Related Side Effects and Adverse Reactions / Q000139:chemically induced / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D011799:Quinazolines / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use*; D012189:Retrospective Studies; D013920:Thrombocythemia, Essential / Q000188:drug therapy* / Q000453:epidemiology*; D028761:Withholding Treatment / Q000706:statistics & numerical data*; D055815:Young Adult
chemical_list: D010975:Platelet Aggregation Inhibitors; D011799:Quinazolines; C021139:anagrelide