Prevention, monitoring and treatment of cardiovascular adverse events in myeloma patients receiving carfilzomib A consensus paper by the European Myeloma Network and the Italian Society of Arterial Hypertension

S. Bringhen, A. Milan, M. D'Agostino, C. Ferri, R. Wäsch, F. Gay, A. Larocca, M. Offidani, S. Zweegman, E. Terpos, H. Goldschmidt, M. Cavo, H. Ludwig, C. Driessen, H. W. Auner, J. Caers, M. Gramatzki, M. A. Dimopoulos, M. Boccadoro, H. Einsele & 2 others P. Sonneveld, M. Engelhardt

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Background: The novel proteasome inhibitor carfilzomib alone or in combination with other agents is already one of the standard therapies for relapsed and/or refractory multiple myeloma (MM) patients and produces impressive response rates in newly diagnosed MM as well. However, carfilzomib-related cardiovascular adverse events (CVAEs) – including hypertension (all grades: 12.2%; grade ≥3: 4.3%), heart failure (all grades: 4.1%; grade ≥3: 2.5%) and ischemic heart disease (all grades: 1.8%; grade ≥3: 0.8%) – may lead to treatment suspensions. At present, there are neither prospective studies nor expert consensus on the prevention, monitoring and treatment of CVAEs in myeloma patients treated with carfilzomib. Methods: An expert panel of the European Myeloma Network in collaboration with the Italian Society of Arterial Hypertension and with the endorsement of the European Hematology Association aimed to provide recommendations to support health professionals in selecting the best management strategies for patients, considering the impact on outcome and the risk-benefit ratio of diagnostic and therapeutic tools, thereby achieving myeloma response with novel combination approaches whilst preventing CVAEs. Results: Patients scheduled to receive carfilzomib need a careful cardiovascular evaluation before treatment and an accurate follow-up during treatment. Conclusions: A detailed clinical assessment before starting carfilzomib treatment is essential to identify patients at risk for CVAEs, and accurate monitoring of blood pressure and of early signs and symptoms suggestive of cardiac dysfunction remains pivotal to safely administer carfilzomib without treatment interruptions or dose reductions.
Original languageEnglish
JournalJournal of Internal Medicine
DOIs
Publication statusPublished - 2019

Cite this

Bringhen, S. ; Milan, A. ; D'Agostino, M. ; Ferri, C. ; Wäsch, R. ; Gay, F. ; Larocca, A. ; Offidani, M. ; Zweegman, S. ; Terpos, E. ; Goldschmidt, H. ; Cavo, M. ; Ludwig, H. ; Driessen, C. ; Auner, H. W. ; Caers, J. ; Gramatzki, M. ; Dimopoulos, M. A. ; Boccadoro, M. ; Einsele, H. ; Sonneveld, P. ; Engelhardt, M. / Prevention, monitoring and treatment of cardiovascular adverse events in myeloma patients receiving carfilzomib A consensus paper by the European Myeloma Network and the Italian Society of Arterial Hypertension. In: Journal of Internal Medicine. 2019.
@article{f1597bf44e0347b994cc07e2a74622ca,
title = "Prevention, monitoring and treatment of cardiovascular adverse events in myeloma patients receiving carfilzomib A consensus paper by the European Myeloma Network and the Italian Society of Arterial Hypertension",
abstract = "Background: The novel proteasome inhibitor carfilzomib alone or in combination with other agents is already one of the standard therapies for relapsed and/or refractory multiple myeloma (MM) patients and produces impressive response rates in newly diagnosed MM as well. However, carfilzomib-related cardiovascular adverse events (CVAEs) – including hypertension (all grades: 12.2{\%}; grade ≥3: 4.3{\%}), heart failure (all grades: 4.1{\%}; grade ≥3: 2.5{\%}) and ischemic heart disease (all grades: 1.8{\%}; grade ≥3: 0.8{\%}) – may lead to treatment suspensions. At present, there are neither prospective studies nor expert consensus on the prevention, monitoring and treatment of CVAEs in myeloma patients treated with carfilzomib. Methods: An expert panel of the European Myeloma Network in collaboration with the Italian Society of Arterial Hypertension and with the endorsement of the European Hematology Association aimed to provide recommendations to support health professionals in selecting the best management strategies for patients, considering the impact on outcome and the risk-benefit ratio of diagnostic and therapeutic tools, thereby achieving myeloma response with novel combination approaches whilst preventing CVAEs. Results: Patients scheduled to receive carfilzomib need a careful cardiovascular evaluation before treatment and an accurate follow-up during treatment. Conclusions: A detailed clinical assessment before starting carfilzomib treatment is essential to identify patients at risk for CVAEs, and accurate monitoring of blood pressure and of early signs and symptoms suggestive of cardiac dysfunction remains pivotal to safely administer carfilzomib without treatment interruptions or dose reductions.",
author = "S. Bringhen and A. Milan and M. D'Agostino and C. Ferri and R. W{\"a}sch and F. Gay and A. Larocca and M. Offidani and S. Zweegman and E. Terpos and H. Goldschmidt and M. Cavo and H. Ludwig and C. Driessen and Auner, {H. W.} and J. Caers and M. Gramatzki and Dimopoulos, {M. A.} and M. Boccadoro and H. Einsele and P. Sonneveld and M. Engelhardt",
year = "2019",
doi = "10.1111/joim.12882",
language = "English",
journal = "Journal of Internal Medicine",
issn = "0954-6820",
publisher = "Wiley-Blackwell",

}

Bringhen, S, Milan, A, D'Agostino, M, Ferri, C, Wäsch, R, Gay, F, Larocca, A, Offidani, M, Zweegman, S, Terpos, E, Goldschmidt, H, Cavo, M, Ludwig, H, Driessen, C, Auner, HW, Caers, J, Gramatzki, M, Dimopoulos, MA, Boccadoro, M, Einsele, H, Sonneveld, P & Engelhardt, M 2019, 'Prevention, monitoring and treatment of cardiovascular adverse events in myeloma patients receiving carfilzomib A consensus paper by the European Myeloma Network and the Italian Society of Arterial Hypertension' Journal of Internal Medicine. https://doi.org/10.1111/joim.12882

Prevention, monitoring and treatment of cardiovascular adverse events in myeloma patients receiving carfilzomib A consensus paper by the European Myeloma Network and the Italian Society of Arterial Hypertension. / Bringhen, S.; Milan, A.; D'Agostino, M.; Ferri, C.; Wäsch, R.; Gay, F.; Larocca, A.; Offidani, M.; Zweegman, S.; Terpos, E.; Goldschmidt, H.; Cavo, M.; Ludwig, H.; Driessen, C.; Auner, H. W.; Caers, J.; Gramatzki, M.; Dimopoulos, M. A.; Boccadoro, M.; Einsele, H.; Sonneveld, P.; Engelhardt, M.

In: Journal of Internal Medicine, 2019.

Research output: Contribution to journalArticleAcademicpeer-review

TY - JOUR

T1 - Prevention, monitoring and treatment of cardiovascular adverse events in myeloma patients receiving carfilzomib A consensus paper by the European Myeloma Network and the Italian Society of Arterial Hypertension

AU - Bringhen, S.

AU - Milan, A.

AU - D'Agostino, M.

AU - Ferri, C.

AU - Wäsch, R.

AU - Gay, F.

AU - Larocca, A.

AU - Offidani, M.

AU - Zweegman, S.

AU - Terpos, E.

AU - Goldschmidt, H.

AU - Cavo, M.

AU - Ludwig, H.

AU - Driessen, C.

AU - Auner, H. W.

AU - Caers, J.

AU - Gramatzki, M.

AU - Dimopoulos, M. A.

AU - Boccadoro, M.

AU - Einsele, H.

AU - Sonneveld, P.

AU - Engelhardt, M.

PY - 2019

Y1 - 2019

N2 - Background: The novel proteasome inhibitor carfilzomib alone or in combination with other agents is already one of the standard therapies for relapsed and/or refractory multiple myeloma (MM) patients and produces impressive response rates in newly diagnosed MM as well. However, carfilzomib-related cardiovascular adverse events (CVAEs) – including hypertension (all grades: 12.2%; grade ≥3: 4.3%), heart failure (all grades: 4.1%; grade ≥3: 2.5%) and ischemic heart disease (all grades: 1.8%; grade ≥3: 0.8%) – may lead to treatment suspensions. At present, there are neither prospective studies nor expert consensus on the prevention, monitoring and treatment of CVAEs in myeloma patients treated with carfilzomib. Methods: An expert panel of the European Myeloma Network in collaboration with the Italian Society of Arterial Hypertension and with the endorsement of the European Hematology Association aimed to provide recommendations to support health professionals in selecting the best management strategies for patients, considering the impact on outcome and the risk-benefit ratio of diagnostic and therapeutic tools, thereby achieving myeloma response with novel combination approaches whilst preventing CVAEs. Results: Patients scheduled to receive carfilzomib need a careful cardiovascular evaluation before treatment and an accurate follow-up during treatment. Conclusions: A detailed clinical assessment before starting carfilzomib treatment is essential to identify patients at risk for CVAEs, and accurate monitoring of blood pressure and of early signs and symptoms suggestive of cardiac dysfunction remains pivotal to safely administer carfilzomib without treatment interruptions or dose reductions.

AB - Background: The novel proteasome inhibitor carfilzomib alone or in combination with other agents is already one of the standard therapies for relapsed and/or refractory multiple myeloma (MM) patients and produces impressive response rates in newly diagnosed MM as well. However, carfilzomib-related cardiovascular adverse events (CVAEs) – including hypertension (all grades: 12.2%; grade ≥3: 4.3%), heart failure (all grades: 4.1%; grade ≥3: 2.5%) and ischemic heart disease (all grades: 1.8%; grade ≥3: 0.8%) – may lead to treatment suspensions. At present, there are neither prospective studies nor expert consensus on the prevention, monitoring and treatment of CVAEs in myeloma patients treated with carfilzomib. Methods: An expert panel of the European Myeloma Network in collaboration with the Italian Society of Arterial Hypertension and with the endorsement of the European Hematology Association aimed to provide recommendations to support health professionals in selecting the best management strategies for patients, considering the impact on outcome and the risk-benefit ratio of diagnostic and therapeutic tools, thereby achieving myeloma response with novel combination approaches whilst preventing CVAEs. Results: Patients scheduled to receive carfilzomib need a careful cardiovascular evaluation before treatment and an accurate follow-up during treatment. Conclusions: A detailed clinical assessment before starting carfilzomib treatment is essential to identify patients at risk for CVAEs, and accurate monitoring of blood pressure and of early signs and symptoms suggestive of cardiac dysfunction remains pivotal to safely administer carfilzomib without treatment interruptions or dose reductions.

UR - https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85064094802&origin=inward

UR - https://www.ncbi.nlm.nih.gov/pubmed/30725503

U2 - 10.1111/joim.12882

DO - 10.1111/joim.12882

M3 - Article

JO - Journal of Internal Medicine

JF - Journal of Internal Medicine

SN - 0954-6820

ER -