title: [Lacidipine efficacy and safety for high blood pressure treatment in pediatric oncohematology].
abstract: In adults, lacidipine seems to have no CYP3A4-inhibiting action. This particular characteristic makes it advantageous when combined with drugs metabolized by CYP3A4, such as cyclosporine. Until now, no data on the efficacy or safety of this calcium antagonist have been available in children. Thirty-nine hypertensive children (age: 0.13-14 years) receiving lacidipine in oncohematology for a mean of 75 days were included in this retrospective study. The causes of high blood pressure were renal tumor (n=7), catecholamine-secreting tumor (n=4), corticoid treatment (n=5), and cyclosporine treatment (n=23). An initial dosage of 0.05 mg/kg/day was sufficient for 41% of the patients. The remaining patients needed to increase the dosage, by steps of 0.03 mg/kg/day, until reaching an average effective dosage of 0.1 mg/kg/day. Lacidipine significantly decreased blood pressure by 30 (±14) mmHg for systolic blood pressure and by 26 (±13) mmHg for diastolic blood pressure. A medication plan with twice-daily administration was not significantly more effective than a single administration per day. Lacidipine was well tolerated, and no toxicity-related withdrawal of treatment occurred. For 22 patients treated with both cyclosporine and lacidipine, renal function was not disturbed over time, suggesting its preservation by lacidipine. No significant increase in cyclosporine blood concentration was detected. Lacidipine seems to be an effective calcium antagonist in pediatric oncohematology, is well tolerated, has a kidney-protector effect and no drug interaction when combined with cyclosporine.
authors.affiliation: Institut d'hématologie et d'oncologie pédiatrique, 1, place Joseph-Renaut, 69008 Lyon, France.
authors.forename: E
authors.initials: E
authors.lastname: Bernard
authors.affiliation: Institut d'hématologie et d'oncologie pédiatrique, 1, place Joseph-Renaut, 69008 Lyon, France.
authors.forename: V
authors.initials: V
authors.lastname: Mialou
authors.affiliation: Institut d'hématologie et d'oncologie pédiatrique, 1, place Joseph-Renaut, 69008 Lyon, France.
authors.forename: A
authors.initials: A
authors.lastname: Dony
authors.affiliation: Institut d'hématologie et d'oncologie pédiatrique, 1, place Joseph-Renaut, 69008 Lyon, France.
authors.forename: N
authors.initials: N
authors.lastname: Garnier
authors.affiliation: Institut d'hématologie et d'oncologie pédiatrique, 1, place Joseph-Renaut, 69008 Lyon, France.
authors.forename: C
authors.initials: C
authors.lastname: Renard
authors.affiliation: Institut d'hématologie et d'oncologie pédiatrique, 1, place Joseph-Renaut, 69008 Lyon, France. Electronic address: nathalie.bleyzac@chu-lyon.fr.
authors.forename: N
authors.initials: N
authors.lastname: Bleyzac
mesh_terms: D000293:Adolescent; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D016572:Cyclosporine / Q000009:adverse effects; D004095:Dihydropyridines / Q000627:therapeutic use*; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005260:Female; D005919:Glomerular Filtration Rate; D005938:Glucocorticoids / Q000009:adverse effects; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000209:etiology; D007166:Immunosuppressive Agents / Q000009:adverse effects; D007223:Infant; D008297:Male; D009369:Neoplasms / Q000150:complications; D012189:Retrospective Studies
chemical_list: D000959:Antihypertensive Agents; D004095:Dihydropyridines; D005938:Glucocorticoids; D007166:Immunosuppressive Agents; C060285:lacidipine; D016572:Cyclosporine