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Meta-Analysis
. 2014 Mar;16(3):177-85.
doi: 10.1111/jch.12273.

Incidence and risk of sorafenib-induced hypertension: a systematic review and meta-analysis

Yan Li, Shun Li, Yaofeng Zhu, Xinyue Liang, Hui Meng, Jun Chen, Dongqing Zhang, Hu Guo, Benkang Shi
Meta-Analysis

Incidence and risk of sorafenib-induced hypertension: a systematic review and meta-analysis

Yan Li et al. J Clin Hypertens (Greenwich). 2014 Mar.

Abstract

Hypertension is one of the major side effects of sorafenib, and reported incidences vary substantially among clinical trials. A systematic review was conducted using Medline, PubMed, Embase, and the Cochrane Library for all longitudinal studies to investigate the incidence and risk of hypertension events in cancer patients treated with sorafenib. A total of 14 randomized controlled trials and 39 prospective single-arm trials involving 13,555 patients were selected for the meta-analysis. The relative risk of all-grade and high-grade hypertension associated with sorafenib were 3.07 (95% confidence interval [CI], 2.05–4.60; P<.01) and 3.31 (95% CI, 2.21–4.95; P<.01), respectively. The overall incidence of sorafenib-induced all-grade and high-grade hypertension were 19.1% (95% CI, 15.8%–22.4%) and 4.3% (95% CI, 3.0%–5.5%), respectively. A significantly higher incidence of hypertension was noted in patients with renal cell carcinoma (RCC) compared with those with non-RCC malignancies (all-grade: 24.9% [95% CI, 19.7%–30.1%] vs 15.7%[95% CI, 12.1%–19.3%]; P<.05; high-grade:8.6% [95% CI, 6.0%–11.2%] vs 1.8% [95% CI, 0.9%–2.6%]; P<.05). The trials with median progression-free survival (PFS) longer than 5.3 months (mean PFS) demonstrated a significantly higher incidence of high-grade hypertension than trials with shorter PFS (6.3% [95% CI, 4.1%–8.5%] vs 2.6% [95% CI, 1.4%– 3.8%]; P<.05). Findings of the meta-analysis indicated a significantly high risk of sorafenib-induced hypertension. Patients with RCC have a significantly higher incidence of hypertension and the occurrence of hypertension may be associated with improved prognosis.

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Figures

Figure 1
Figure 1
Selection process for trials.
Figure 2
Figure 2
Meta‐analysis of the relative risk (RR) of developing all‐grade hypertension in cancer patients receiving sorafenib. CI indicates confidence interval.
Figure 3
Figure 3
Meta‐analysis of the relative risk (RR) of developing high‐grade hypertension in cancer patients receiving sorafenib. CI indicates confidence interval.
Figure 4
Figure 4
Meta‐analysis of incidence of high‐grade hypertension in cancer patients receiving sorafenib. ES indicates effect size; CI, confidence interval.
Figure 5
Figure 5
Funnel plot of the meta‐analysis (relative risk [RR] for high‐grade hypertension).
See this image and copyright information in PMC

Comment in

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