ベバシズマブによる蛋白尿発現のリスク因子とレニン－アンジオテンシン系抑制薬の影響についての検討

抄録

We examined risk factors for the onset of proteinuria with the bevacizumab (Bmab) administration, change in blood pressure, and the ratio of onset of proteinuria according to the type of combination of antihypertensive medications of the patients who received Bmab combination chemotherapy at Ogaki Municipal Hospital between April 2012 and March 2015, and 38.9% (61/157 cases) developed proteinuria. The blood pressure at the onset of proteinuria was significantly higher than that before treatment (P < 0.01).
Multivariate logistic regression analysis, showed that systolic blood pressure (≥126 mmHg; P < 0.01), diastolic blood pressure (≥72 mmHg; P = 0.02), and Bmab 1 time dose (≥570 mg/dose; P = 0.04) were risk factors for the onset of proteinuria. Among hypotensive treatment, a significantly lower proteinuria incidence was seen in patients receiving angiotensin II receptor blocker (ARB) treatment (13.3%) than in those receiving calcium-channel blockers treatment (51.9%; P = 0.02). Bmab 1 time dose (≥570 mg/dose), systolic blood pressure (≥126 mmHg), and diastolic blood pressure(≥72 mmHg), are considered to lead to a decrease in the frequency of proteinuria onset when ARB therapy is started early after the increase in blood pressure.