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. 2010 Aug 24;103(5):617-21.
doi: 10.1038/sj.bjc.6605807. Epub 2010 Jul 27.

The frequency and severity of capecitabine-induced hypertriglyceridaemia in routine clinical practice: a prospective study

C O Michie  1 , M Sakala, I Rivans, M W J Strachan, S Clive
Affiliations

The frequency and severity of capecitabine-induced hypertriglyceridaemia in routine clinical practice: a prospective study

C O Michie et al. Br J Cancer. .

Abstract

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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Figures

Figure 1
Figure 1
Patient flow diagram.
Figure 2
Figure 2
Triglyceride (TG) levels over time in eight patients with capecitabine-induced hypertriglyceridaemia requiring lipid-lowering therapy. The colour reproduction of this figure is available on the html full text version of the manuscript.
See this image and copyright information in PMC

Comment in

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