{"id":14598,"date":"2021-04-30T08:23:31","date_gmt":"2021-04-30T06:23:31","guid":{"rendered":"https:\/\/convergences.online\/hemato\/?p=14598"},"modified":"2024-12-11T13:05:57","modified_gmt":"2024-12-11T12:05:57","slug":"traitements-par-inhibiteurs-de-parp-et-risque-de-smd","status":"publish","type":"post","link":"https:\/\/www.hematostat.net\/en\/traitements-par-inhibiteurs-de-parp-et-risque-de-smd\/","title":{"rendered":"Traitements par inhibiteurs de PARP et risque de SMD"},"content":{"rendered":"
R\u00e9f. : HematoStat.net ; 2 (1) : R7<\/span><\/div>\n
<\/div>\n
Myelodysplastic syndrome and acute myeloid leukaemia in patients treated with PARP inhibitors: a safety meta-analysis of randomised controlled trials and a retrospective study of the WHO pharmacovigilance databa<\/em>se<\/span><\/strong><\/div>\n
<\/div>\n
\n
Morice, P.-M. and al. Myelodysplastic syndrome and acute myeloid leukaemia in patients treated with PARP inhibitors: a safety meta-analysis of randomised controlled trials and a retrospective study of the WHO pharmacovigilance database. <\/span>Lancet Haematol. 8, e122\u2013e134 (2021).<\/i><\/div>\n<\/div>\n
<\/div>\n
\n

R\u00e9sum\u00e9 :<\/h3>\n

Les inhibiteurs de PARP (iPARP) sont utilis\u00e9s dans le traitement des cancers de l\u2019ovaire et des doutes \u00e9mergent sur un possible risque accru de d\u00e9velopper un SMD ou une LAM secondaire. Cette m\u00e9ta-analyse est bas\u00e9e sur 28 essais cliniques randomis\u00e9s (5693 patients trait\u00e9s par iPARP, 3406 dans des groupes placebo). L\u2019incidence des SMD\/LAM \u00e9tait de 0,73 % contre 0,47 % dans les groupes placebo avec un d\u00e9lai m\u00e9dian suivant la 1re <\/sup>exposition de 17,8 mois (8,4\u201329,2 ; n=58).<\/p>\n

Dans nos pratiques :<\/h3>\n

Cette m\u00e9ta-analyse qui confirme les craintes quant aux risques de survenue d\u2019h\u00e9mopathie secondaire apr\u00e8s traitement par iPARP, montre \u00e9galement l\u2019importance des d\u00e9clarations de pharmacovigilance. En effet, le suivi limit\u00e9 de certains essais ne permet pas forc\u00e9ment de d\u00e9tecter ce type d\u2019\u00e9v\u00e9nement, rare et de survenue parfois tardive. Il serait int\u00e9ressant de pouvoir identifier avant traitement les patients les plus \u00e0 risque (pr\u00e9sence d\u2019h\u00e9matopo\u00ef\u00e8se clonale ?).<\/p>\n

Le regard du statisticien :<\/strong><\/h3>\n

La m\u00e9ta-analyse suit le gold standard <\/em>du point de vue m\u00e9thodologie et les essais cliniques retenus pour cette synth\u00e8se semblent tous tr\u00e8s robustes, ce qui aboutit cette conclusion qui interpelle quant \u00e0 un risque accru de survenue de SMD\/LAM secondaire. Cette \u00e9tude rappelle aussi, comme indiqu\u00e9 plus haut, l\u2019int\u00e9r\u00eat primordial du suivi par la pharmacovigilance dans la d\u00e9tection d\u2019\u00e9v\u00e9nements ind\u00e9sirables graves, qui ici viennent conforter h\u00e9las les r\u00e9sultats.<\/p>\n<\/div>\n<\/div><\/div><\/div><\/div><\/div>","protected":false},"excerpt":{"rendered":"","protected":false},"author":16,"featured_media":14594,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_monsterinsights_skip_tracking":false,"_monsterinsights_sitenote_active":false,"_monsterinsights_sitenote_note":"","_monsterinsights_sitenote_category":0,"_uf_show_specific_survey":0,"_uf_disable_surveys":false,"footnotes":""},"categories":[36],"tags":[60,61,37],"ppma_author":[456],"class_list":["post-14598","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-revue-de-presse","tag-inhibiteurs-de-parp","tag-lam","tag-smd","author-alexis-genthon"],"aioseo_notices":[],"authors":[{"term_id":456,"user_id":16,"is_guest":0,"slug":"alexis-genthon","display_name":"Alexis GENTHON","avatar_url":{"url":"https:\/\/www.hematostat.net\/wp-content\/uploads\/2023\/06\/Capture-decran-2021-05-07-a-14.25.02.png","url2x":"https:\/\/www.hematostat.net\/wp-content\/uploads\/2023\/06\/Capture-decran-2021-05-07-a-14.25.02.png"},"first_name":"","last_name":"","user_url":"","description":"H\u00e9matologue.\r\nCorrespondance : H\u00f4pital Saint-Antoine \r\nService h\u00e9matologie clinique\r\n184 rue du Faubourg Saint-Antoine 75012 Paris."}],"_links":{"self":[{"href":"https:\/\/www.hematostat.net\/en\/wp-json\/wp\/v2\/posts\/14598","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.hematostat.net\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.hematostat.net\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.hematostat.net\/en\/wp-json\/wp\/v2\/users\/16"}],"replies":[{"embeddable":true,"href":"https:\/\/www.hematostat.net\/en\/wp-json\/wp\/v2\/comments?post=14598"}],"version-history":[{"count":1,"href":"https:\/\/www.hematostat.net\/en\/wp-json\/wp\/v2\/posts\/14598\/revisions"}],"predecessor-version":[{"id":18174,"href":"https:\/\/www.hematostat.net\/en\/wp-json\/wp\/v2\/posts\/14598\/revisions\/18174"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.hematostat.net\/en\/wp-json\/"}],"wp:attachment":[{"href":"https:\/\/www.hematostat.net\/en\/wp-json\/wp\/v2\/media?parent=14598"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.hematostat.net\/en\/wp-json\/wp\/v2\/categories?post=14598"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.hematostat.net\/en\/wp-json\/wp\/v2\/tags?post=14598"},{"taxonomy":"author","embeddable":true,"href":"https:\/\/www.hematostat.net\/en\/wp-json\/wp\/v2\/ppma_author?post=14598"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}