title: Incidence and risk of hypertension with ramucirumab in cancer patients: a meta-analysis of published studies.
abstract: OBJECTIVE
  Ramucirumab is a novel antiangiogenic agent approved as second-line therapy for patients with advanced stomach cancer and gastroesophageal junction adenocarcinoma. Although existing evidence from clinical trials has demonstrated hypertension is one of the major adverse events of this agent, overall risks have yet to be reported.
  
  
  METHODS
  We carried out a meta-analysis of published studies to determine the overall incidence and relative risk (RR) of hypertension associated with ramucirumab. Statistical analyses were conducted to calculate the summary incidence, RRs, and 95 % confidence intervals (CIs) by using a random effects model.
  
  
  RESULTS
  Eleven studies with a total of 3,851 patients with multiple cancers were included. The overall incidence of all-grade hypertension was 20.0 % (95 % CI 15.0-26.0) with 8.6 % (95 % CI 6.3-11.7) being high-grade hypertension. The risk of developing hypertension was greater in ramucirumab-treated patients (RR for all grades 2.77, 95 % CI 1.94-3.94, p < 0.001, RR for high-grade 3.58, 95 % CI 2.45-5.23, p < 0.001).
  
  
  CONCLUSIONS
  Administration of ramucirumab to patients with cancer is associated with increased risk of hypertension.
authors.affiliation: Department of General Surgery, Jiansu Province of Traditional Chinese Medicine, 100 Shizi Street, Hongshan Road, Nanjing, 210028, Jiangsu, People's Republic of China.
authors.forename: Jianhua
authors.initials: J
authors.lastname: Wang
authors.forename: Zexing
authors.initials: Z
authors.lastname: Wang
authors.forename: Yunzhao
authors.initials: Y
authors.lastname: Zhao
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D020533:Angiogenesis Inhibitors / Q000009:adverse effects / Q000627:therapeutic use; D000911:Antibodies, Monoclonal / Q000009:adverse effects* / Q000627:therapeutic use; D061067:Antibodies, Monoclonal, Humanized; D005260:Female; D006801:Humans; D006973:Hypertension / Q000139:chemically induced* / Q000453:epidemiology*; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications / Q000188:drug therapy*; D012307:Risk Factors; D055815:Young Adult; D000096662:Ramucirumab
chemical_list: D020533:Angiogenesis Inhibitors; D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D000096662:Ramucirumab