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01 Dec 2020
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Carfilzomib comes with unpredictable renal complications in RRMM

10 Dec 2020

Renal complications associated with carfilzomib (CFZ) treatment among relapsed and refractory multiple myeloma (RRMM) patients are common and unpredictable, though they develop early after treatment initiation, a recent study has found.

The study included 114 consecutive RRMM patients (median age, 70 years; 60.5 percent male) undergoing CFZ treatment. All participants had undergone close monitoring and evaluation for renal complications, including renal biopsies. Events deemed to be linked to MM progression were not counted as treatment-related.

Over a median follow-up of 27 months from the start of CFZ initiation, 19 patients developed renal complications unrelated to disease progression. The resulting incidence rate was 17 percent. The median duration of CFZ treatment was 5.5 months, and at the time of analysis, 28 patients were still undergoing treatment.

The renal complications documented included thrombotic microangiopathy (5 percent), acute kidney injury grade ≥3 (5 percent), and albuminuria >1 g per day with very low serum free light chains or negative immunofixation (6 percent). Fifteen of the 19 patients who developed such complications eventually discontinued CFZ treatment.

The renal complications developed relatively early during treatment, with most manifesting within 2–3 months; albuminuria, however, developed later at a median of 6 months.

Notably, no significant predictor for treatment-related renal complications was found. Baseline factors such as proteinuria, myeloma subtype, patient age, previous treatments, CFZ dose and regimen, kidney function, and comorbidities were all unrelated to the risk of developing such complications.

“Further investigation of the underlying mechanisms of CFZ-induced nephrotoxicity is needed in order to predict and manage these complications and provide this active drug with safety,” the researchers said.

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Most Read Articles
01 Dec 2020
Tetanus toxoid 5 Lf, diphtheria toxoid 2 Lf, pertussis toxoid 2.5 mcg, filamentous haemagglutinin 5 mcg, fimbriae types 2 and 3 5 mcg, pertactin 3 mcg
Dr. Hsu Li Yang, Dr. Tan Thuan Tong, Dr. Andrea Kwa, 08 Jan 2021
Antimicrobial resistance has become increasingly dire as the rapid emergence of drug resistance, especially gram-negative pathogens, has outpaced the development of new antibiotics. At a recent virtual symposium, Dr Hsu Li Yang, Vice Dean (Global Health) and Programme Leader (Infectious Diseases), NUS Saw Swee Hock School of Public Health, presented epidemiological data on multidrug-resistant (MDR) gram-negative bacteria (GNB) in Asia, while Dr Tan Thuan Tong, Head and Senior Consultant, Department of Infectious Diseases, Singapore General Hospital (SGH), focused on the role of ceftazidime-avibactam in MDR GNB infections. Dr Andrea Kwa, Assistant Director of Research, Department of Pharmacy, SGH, joined the panel in an interactive fireside chat, to discuss challenges, practical considerations, and solutions in MDR gram-negative infections. This Pfizer-sponsored symposium was chaired by Dr Ng Shin Yi, Head and Senior Consultant of Surgical Intensive Care, SGH.
Pearl Toh, 26 Nov 2020
Inhaled corticosteroid (ICS) should be the mainstay of long-term asthma management — such is the key message of the latest Singapore ACE* Clinical Guidance (ACG) for asthma, released in October 2020.
2 days ago
Among patients with moderate-to-severe psoriasis, the use of biologics appears to lower the risk of being hospitalized for the novel coronavirus disease (COVID-19), a new study has found.