Key result
Capecitabine therapy is linked to a ~4% incidence of clinically significant hypertriglyceridemia requiring treatment.
Why the study?
Capecitabine is known to rarely cause raised serum triglycerides, but the incidence and severity of capecitabine-induced hypertriglyceridaemia in routine clinical practice were unclear.
What is the incidence of clinically significant hypertriglyceridaemia in patients receiving capecitabine for colorectal cancer?
Observational (n=304)
No
What is the incidence of clinically significant hypertriglyceridaemia in patients receiving capecitabine for colorectal cancer?
Capecitabine-induced hypertriglyceridaemia is a common adverse effect occurring in approximately 3.7% of patients, warranting targeted lipid screening in those with diabetes or pre-existing hyperlipidaemia.
May support lipid monitoring with capecitabine; leaves open whether screening improves cardiovascular outcomes.
BACKGROUND: Capecitabine is known to rarely cause raised serum triglycerides (TG). In our centre, several patients receiving capecitabine developed raised TG levels corresponding to the 'very high risk' category for potentially serious acute pancreatitis. METHODS: A fasting blood lipid screening protocol was introduced into clinical practice for patients receiving capecitabine. Patients with TGs >5 mmol l(-1) were treated and followed up. An 18-month prospective audit was performed to establish the incidence and severity of capecitabine-induced hypertriglyceridaemia (CIHT). RESULTS: A total of 304 patients received capecitabine for colorectal cancer between January 2008 and June 2009. Of these, 212 patients (70%) were screened and 8 (3.7%) developed clinically significant hypertriglyceridaemia requiring lipid-lowering therapy. Two of the eight patients had diabetes and one had pre-existing dyslipidaemia. One suffered cerebral infarction during chemotherapy. There were no cases of acute pancreatitis. Follow-up showed that serum TGs safely and rapidly returned to normal with appropriate treatment without discontinuation of capecitabine. CONCLUSIONS: This is the first prospective study evaluating CIHT. These results suggest that it should be classed as a 'common' undesired effect of capecitabine. Despite this, the incidence does not justify routine screening in all patients. Targeted screening in those with diabetes or pre-existing hyperlipidaemia is recommended, together with adoption of a clear management policy.
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Michie et al. (2010) conducted an observational in Colorectal cancer (n=304). Capecitabine was evaluated on Incidence of clinically significant hypertriglyceridaemia requiring lipid-lowering therapy. Capecitabine therapy was associated with a 3.7% incidence of clinically significant hypertriglyceridaemia requiring lipid-lowering therapy among screened patients with colorectal cancer.
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