Drug interactions with tyrosine kinase inhibitors in chronic myeloid leukemia (CML)

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In a nutshell

This study investigated the interactions between tyrosine kinase inhibitors and other drugs taken at the same time in patients with chronic myeloid leukemia. This study concluded that drug interactions were found in a significant number of patients, with mild side effects.

Some background

Imatinib (Gleevec) and similar drugs are the standard therapy for chronic myeloid leukemia (CML). Imatinib is a tyrosine kinase (TK) inhibitor. This type of treatment is a targeted therapy. This treatment blocks cancer cell survival. This leads to cancer cell death.

TK inhibitors are known to have serious interactions with other drugs. How often these interactions occur and whether there are side effects remains under investigation in patients with chronic myeloid leukemia.

Methods & findings

This study determined whether tyrosine kinase inhibitors interacted with other drugs taken at the same time in patients with chronic myeloid leukemia. This study included records from 105 patients. Patients were already taking an average of 4.8 medications. Therapies included imatinib, nilotinib (Tasigna), dasatinib (Sprycel), bosutinib (Bosulif), and ponatinib (Iclusig). The average follow-up period was 28 months.

Overall, 159 drug interactions were found. Of these, 64% were not severe and 16% were high-risk. The most common interacting drugs included proton pump inhibitors (16%), statins (16%), and antidepressants (11%).

60% of patients experienced at least one drug interaction. Patients who were taking fewer than 4 medications reported significantly fewer drug interactions (0.4) than those taking 4 or more medications (2 interactions). 20% of patients experienced side effects or reduced effectiveness. 30% of patients switched treatment to another TK inhibitor.

Overall, side effects were reported in 82% of patients who experienced drug interactions. Most of the reported side effects were mild. These included muscle pain (10.8%), edema (swelling in the hands, legs, or feet from water retention; 9.9%), and diarrhea (6.7%). High liver enzymes (4.5%) and vomiting (3.6%) were also reported.

The bottom line

This study concluded that drug interactions were found in a significant number of CML patients, with mild side effects. 

The fine print

This study was retrospective, meaning it looked back in time to analyze data.

What's next?

If you have chronic myeloid leukemia, talk to your care team about your current medications before starting TK inhibitor therapy.


Published By :

Annals of Hematology

Date :

Jun 28, 2018

Original Title :

Drug-to-drug interactions of tyrosine kinase inhibitors in chronic myeloid leukemia patients. Is it a real problem?

Please consult your physician as to how this study may relate to your specific condition. You may also call an LLS information specialist at 1-800-955-4572.
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