title: Congestive heart failure with vascular endothelial growth factor receptor tyrosine kinase inhibitors.
abstract: A systematic review and meta-analysis was conducted to determine the relative risk (RR) of congestive heart failure (CHF) associated with approved multi-targeted vascular endothelial growth factor receptor (VEGFR) tyrosine kinase inhibitors (TKI). Eligible studies included randomized trials comparing arms with and without an FDA-approved VEGFR TKI. Statistical analyses calculated the relative risk (RR) and 95% confidence intervals (CI). A total of 10,647 patients from 16 phase III trials and 5 phase II trials were selected. All grade CHF occurred in 138 of 5752 (2.39%) patients receiving VEGFR TKIs and 37 of 4895 (0.75%) patients in the non-TKI group. High-grade CHF occurred in 17 of 1426 (1.19%) patients receiving VEGFR TKIs and 8 of 1232 (0.65%) patients in the non-TKI group. The RR of all grade and high-grade CHF for the TKI vs. no TKI arms was 2.69 (p<0.001; 95% CI: 1.86 to 3.87) and 1.65 (p=0.227, 95% CI: 0.73 to 3.70), respectively. The RR of relatively specific TKIs (axitinib) was similar to relatively non-specific TKIs (sunitinib, sorafenib, vandetanib, pazopanib).
authors.affiliation: Department of Internal Medicine, University of Alabama at Birmingham (UAB), Birmingham, AL, USA.
authors.forename: Pooja
authors.initials: P
authors.lastname: Ghatalia
authors.affiliation: Department of Biostatistics, UAB School of Public Health, Kyung Hee University, Seoul, Republic of Korea.
authors.forename: Charity J
authors.initials: CJ
authors.lastname: Morgan
authors.affiliation: Department of Food and Nutrition, Kyung Hee University, Seoul, Republic of Korea.
authors.forename: Youjin
authors.initials: Y
authors.lastname: Je
authors.affiliation: Dana Farber Cancer Institute, Brigham and Women's Hospital, and Harvard Medical School, Boston, MA, USA.
authors.forename: Paul L
authors.initials: PL
authors.lastname: Nguyen
authors.affiliation: Dana Farber Cancer Institute, Brigham and Women's Hospital, and Harvard Medical School, Boston, MA, USA.
authors.forename: Quoc-Dien
authors.initials: QD
authors.lastname: Trinh
authors.affiliation: Dana Farber Cancer Institute, Brigham and Women's Hospital, and Harvard Medical School, Boston, MA, USA.
authors.forename: Toni K
authors.initials: TK
authors.lastname: Choueiri
authors.affiliation: Department of Internal Medicine, Section of Medical Oncology, UAB Medical Center, Birmingham, AL, USA. Electronic address: gsonpavde@uabmc.edu.
authors.forename: Guru
authors.initials: G
authors.lastname: Sonpavde
mesh_terms: D000970:Antineoplastic Agents / Q000009:adverse effects*; D006333:Heart Failure / Q000209:etiology*; D006801:Humans; D009369:Neoplasms / Q000150:complications* / Q000188:drug therapy; D016017:Odds Ratio; D047428:Protein Kinase Inhibitors / Q000009:adverse effects*; D017594:Publication Bias; D016032:Randomized Controlled Trials as Topic; D040262:Receptors, Vascular Endothelial Growth Factor / Q000037:antagonists & inhibitors*; D012306:Risk
chemical_list: D000970:Antineoplastic Agents; D047428:Protein Kinase Inhibitors; D040262:Receptors, Vascular Endothelial Growth Factor
keywords: Approved; Congestive heart failure; Meta-analysis; Tyrosine kinase inhibitors; Vascular endothelial growth factor receptor