Key clinical point: Treatment with new-generation tyrosine kinase inhibitors (TKIs), i.e., bosutinib, nilotinib, and ponatinib, but not dasatinib, increased the risk of hepatotoxicity compared with imatinib among patients with chronic-phase chronic myeloid leukemia (CML-CP).
Major finding: Overall, patients receiving new-generation TKIs vs imatinib were at an increased risk of all-grade alanine aminotransferase (ALT) elevation (relative risk [RR], 2.89), high-grade ALT elevation (RR, 4.36), all-grade aspartate aminotransferase (AST) elevation (RR, 2.20), and high-grade AST elevation (RR, 2.65; all P < .001). Dasatinib was not associated with an increased risk of ALT or AST elevation.
Study details : Findings are from a systematic review and meta-analysis of 9 studies, including 3,475 patients with CML-CP that compared hepatotoxicity of bosutinib, dasatinib, nilotinib, and ponatinib vs imatinib.
Disclosures: This work was funded by the National Key Research and Development Program of China and the Fundamental Research Funds for the Central Universities. The authors did not report any conflict of interests.
Source: Wang Z et al. JAMA Netw Open. 2021 Jul 22. doi: 10.1001/jamanetworkopen.2021.20165 .