13 research outputs found
Tetany: Possible adverse effect of bevacizumab
Background: Bevacizumab a recombinant humanized monoclonal antibody was
approved in 2004 by US FDA for metastatic colorectal cancer. It is
reported to cause potentially serious toxicities including severe
hypertension, proteinuria, and congestive heart failure. Aim: To
correlate adverse event tetany with the use of bevacizumab. Materials
and Methods : World Health Organization\u2032s Uppsala Monitoring
Centre, Sweden, for reporting of adverse drug reactions from all over
the world, identified 7 cases with tetany-related symptoms to
bevacizumab from four different countries. These 7 patients reported to
UMC database developed adverse events described as musculoskeletal
stiffness (1), muscle spasm (1), muscle cramps (1), lock jaw or jaw
stiffness (4), and hypertonia (1), with hypocalcaemia. Results: After
detailed study of the possible mechanism of actions of bevacizumab and
factors causing tetany, it is proposed that there is a possibility of
tetany by bevacizumab, which may occur by interfering with calcium
metabolism. Resorption of bone through osteoclasts by affecting VEGF
may interfere with calcium metabolism. Another possibility of tetany
may be due to associated hypomagnesaemia, hypokalemia, or hyponatremia.
Conclusions: Tetany should be considered as a one of the signs. Patient
on bevacizumab should carefully watch for tetany-related symptoms and
calcium and magnesium levels for their safety
Tetany: Possible adverse effect of bevacizumab
Background: Bevacizumab a recombinant humanized monoclonal antibody was
approved in 2004 by US FDA for metastatic colorectal cancer. It is
reported to cause potentially serious toxicities including severe
hypertension, proteinuria, and congestive heart failure. Aim: To
correlate adverse event tetany with the use of bevacizumab. Materials
and Methods : World Health Organization′s Uppsala Monitoring
Centre, Sweden, for reporting of adverse drug reactions from all over
the world, identified 7 cases with tetany-related symptoms to
bevacizumab from four different countries. These 7 patients reported to
UMC database developed adverse events described as musculoskeletal
stiffness (1), muscle spasm (1), muscle cramps (1), lock jaw or jaw
stiffness (4), and hypertonia (1), with hypocalcaemia. Results: After
detailed study of the possible mechanism of actions of bevacizumab and
factors causing tetany, it is proposed that there is a possibility of
tetany by bevacizumab, which may occur by interfering with calcium
metabolism. Resorption of bone through osteoclasts by affecting VEGF
may interfere with calcium metabolism. Another possibility of tetany
may be due to associated hypomagnesaemia, hypokalemia, or hyponatremia.
Conclusions: Tetany should be considered as a one of the signs. Patient
on bevacizumab should carefully watch for tetany-related symptoms and
calcium and magnesium levels for their safety
Anaemia and zidovudine-containing antiretroviral therapy in paediatric antiretroviral programmes in the IeDEA Paediatric West African Database to evaluate AIDS
Introduction: There is a risk of anaemia among HIV-infected children on antiretroviral therapy (ART) containing zidovudine (ZDV) recommended in first-line regimens in the WHO guidelines. We estimated the risk of severe anaemia after initiation of a ZDV-containing regimen in HIV-infected children included in the IeDEA West African database. Methods: Standardized collection of data from HIV-infected children (positive PCR<18 months or positive serology ≥18 months) followed up in HIV programmes was included in the regional IeDEA West Africa collaboration. Ten clinical centres from seven countries contributed (Benin, Burkina Faso, Côte d'Ivoire, Gambia, Ghana, Mali and Senegal) to this collection. Inclusion criteria were age <16 years and starting ART. We explored the data quality of haemoglobin documentation over time and the incidence and predictors of severe anaemia (Hb<7g/dL) per 100 child-years of follow-up over the duration of first-line antiretroviral therapy. Results: As of December 2009, among the 2933 children included in the collaboration, 45% were girls, median age was five years; median CD4 cell percentage was 13%; median weight-for-age z-score was−2.7; and 1772 (60.4%) had a first-line ZDV-containing regimen. At baseline, 70% of the children with a first-line ZDV-containing regimen had a haemoglobin measure available versus 76% in those not on ZDV (p≤0.01): the prevalence of severe anaemia was 3.0% (n=38) in the ZDV group versus 10.2% (n=89) in those without (p<0. 01). Over the first-line follow-up, 58.9% of the children had ≥1 measure of haemoglobin available in those exposed to ZDV versus 60.4% of those not (p=0.45). Severe anaemia occurred in 92 children with an incidence of 2.47 per 100 child-years of follow-up in those on a ZDV-containing regimen versus 4.25 in those not (p≤0.01). Adjusted for age at ART initiation and first-line regimen, a weight-for-age z-score ≤−3 was a strong predictor associated with a 5.59 times risk of severe anaemia (p<0.01). Conclusions: Severe anaemia is frequent at baseline and guides the first-line ART prescription, but its incidence seems rare among children on ART. Severe malnutrition at baseline is a strong predictor for development of severe anaemia, and interventions to address this should form an integral component of clinical care