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Cardiovascular Risk With Ponatinib Treatment in CML: Focus on Lipid Profile

By: Joshua Swore
Posted: Wednesday, July 22, 2020

An article published in Blood Cancer Journal emphasized the importance of understanding patient’s lipid profile prior to and during treatment with ponatinib for chronic myeloid leukemia (CML) to reduce the risk of cardiovascular disease. Giovanni Caocci, MD, of the University of Cagliari, Italy, and colleagues commented: “Overall, personalized strategies to minimize the risk of arterial occlusive events should be thoroughly investigated in CML patients undergoing treatment with ponatinib.”

A total of 116 patients with CML treated with ponatinib outside of clinical trials were enrolled in the study. Patients received either 45 mg/day (36%), 30 mg/day (48%), or 15 mg/day (16%). While patients were receiving treatment, their levels of cholesterol, high-density lipoprotein (HDL), low-density lipoprotein (LDL), and triglycerides were monitored.

The frequency of arterial occlusive events was found to be relatively similar between treatment doses, with 31% occurring with 45 mg/day; 38% with 30 mg/day; and 31% with 15 mg/day. The 4-year rate of arterial occlusive events was 26.5 ± 7%, with an overall survival rate of 92.2%. In addition, patients with cholesterol levels higher than 200 mg/dL and LDL levels higher than 70 mg/dL had more arterial occlusive events than did those with lower cholesterol and LDL levels (44.1% vs. 7.7%, P = .001). The incidence rate of arterial occlusive events was also increased in patients with triglyceride levels higher than 200 mg/dL prior to ponatinib treatment.

Furthermore, the incidence of dyslipidemia was found to increase from diagnosis of CML to the start of ponatinib treatment (22% to 35%). Dr. Caocci and colleagues also noted that during treatment, 10 patients were also taking statins. As a result, they recommended a lipid-lowering therapy in conjunction with a change in lifestyle as a potential measure to reduce the risk of cardiovascular disease in patients treated with ponatinib.

Disclosure: The study authors reported no conflicts of interest.

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