Meta-analysis of Adverse Drug Reaction of Hematological System by PARP Inhibitors / 中国药房

ABSTRACT

OBJECTIVE：To evaluate the safety of PARP inhibitors in hematological system ，and to provide evidence-based evidence for rational drug use in the clinic. METHODS ：Retrieved from PubMed ，Embase，Cochrane Library ，ScienceDirect， CNKI，CBM，VIP and Wanfang data from May 2014 to June 2019，randomized controlled trials （RCTs）about PARP inhibitors or PARP inhibitors combined with chemical treatment drugs （trial group ）versus chemical treatment drugs alone ，placebo alone or chemical treatment drugs combined with placebo （control group ）were collected. After literature screening ，data extraction and quality evaluation with bias risk assessment tool recommended by Cochrane systematic evaluator manual 5.1.0，and Meta-analysis was performed by using Rev Man 5.3 software，and sensitivity analysis and publication bias analysis. RESULTS ：A total of 10 RCTs were included ，involving 3 129 patients. Meta-analysis showed that the incidence of anemia ≥grade 3 [RR＝7.27，95％CI （2.74，19.27），P＜0.000 1]，neutropenia≥grade 3 [RR＝2.46，95％CI（1.43，4.24），P＝0.001]，and leukopenia ≥grade 3 in trial group [RR ＝1.71，95％CI（1.15，2.54），P＝0.008] in trial group were significantly higher than control group. There was no statistically significant difference in the incidence of thrombocytopenia ≥grade 3 between two groups [RR ＝3.54，95％CI（0.66， 19.05），P＝0.14]. Results of sub-group analysis showed that the incidence of an emia≥grade 3 and neutropenia ≥grade 3 in the patients receiving PARP inhibitors alone ，PARP inhibitors combined with chemical treatment dr ugs as well as the incidence of leukopenia≥grade 3 in the patients receiving PARP inhibitors （No.2018FH001-096） combined with chemical treatment drugs were significantly higher than those receiving placebo alone ，chemical treatment com drugs alone or chemical treatment drugs combined with placebo （P＜0.05）. Sensitivity analysis supported the above results howerer，publication bias was possibility. CONCLUSIONS ：PARP inhibitor in the treatment of cancer can cause hematological system adverse drug reaction ，mainly manifesting as anemia ，neutropenia and leukopenia. These results should be interpreted with caution.