Nilotinib therapy significantly increased adjusted mean systolic blood pressure by 7 mmHg compared to imatinib over 12 months in patients with chronic myeloid leukemia.
Cohort (n=148)
No
Does nilotinib compared to imatinib cause a greater increase in blood pressure in adult CML patients?
Both imatinib and nilotinib cause significant increases in blood pressure over 12 months in CML patients, with nilotinib demonstrating a more pronounced hypertensive effect.
Effect estimate: Mean difference 7 mmHg (95% CI 4-10)
Absolute Event Rate: 132% vs 125%
p-value: p=<0.001
Abstract Introduction Chronic Myeloid Leukemia is a hematologic malignancy characterized by the BCR-ABL fusion gene. Tyrosine Kinase Inhibitors such as imatinib and nilotinib have significantly improved the prognosis for CML patients. However, prolonged TKI therapy is associated with cardiovascular side effects, particularly hypertension. This study aims to compare the effects of imatinib and nilotinib on blood pressure in CML patients over a 12-month period. Methods A retrospective cohort study was conducted at Wahidin Sudirohusodo Hospital, including 148 adult CML patients who received imatinib or nilotinib for at least 12 months. BP measurements were taken at baseline, and at 3, 6, 9, and 12 months. Statistical analyses included paired t-tests and multivariate regression to evaluate BP changes and their associations with demographic and treatment variables. Results Both systolic and diastolic BP significantly increased in both groups over 12 months. In the imatinib group, systolic BP rose from 112 mmHg to 125 mmHg, and diastolic BP increased from 72 mmHg to 81 mmHg. In the nilotinib group, systolic BP increased from 111 mmHg to 130 mmHg, and diastolic BP rose from 70 mmHg to 83 mmHg. These increases were more pronounced in the nilotinib group (p < 0.001 for systolic and p = 0.006 for diastolic). Conclusion Both imatinib and nilotinib therapies lead to significant increases in BP, with nilotinib showing a greater hypertensive effect. Monitoring BP is crucial, especially for patients on second-generation TKIs, to manage cardiovascular risks associated with long-term treatment.
Anwar et al. (Mon,) conducted a cohort in Chronic Myeloid Leukemia (CML) (n=148). Nilotinib vs. Imatinib was evaluated on Adjusted mean systolic blood pressure at 12 months (Mean difference 7 mmHg, 95% CI 4-10, p=<0.001). Nilotinib therapy significantly increased adjusted mean systolic blood pressure by 7 mmHg compared to imatinib over 12 months in patients with chronic myeloid leukemia.