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Title: | Association of APOA5 and APOC3 genetic polymorphisms with severity of hypertriglyceridemia in patients with cutaneous T-Cell lymphoma treated with bexarotene |
Author: | Cabello Zamora, Irene Alia, Pedro Pintó Sala, Xavier Muniesa Montserrat, Cristina Fernández de Misa, Ricardo Peñate, Yerai Morillo, Mercedes Pérez-Ferriols, Amparo Estrach Panella, Ma. Teresa (María Teresa) Izu, Rosa Gallardo, F. (Fernando) Román, Concepción Cervigón, Iván Ortiz Brugués, Ariadna Ortiz Romero, Pablo L. Servitje Bedate, Octavio |
Keywords: | Polimorfisme genètic Triglicèrids Efectes secundaris dels medicaments Medicaments antineoplàstics Càncer de pell Genetic polymorphisms Triglycerides Drug side effects Antineoplastic agents Skin cancer |
Issue Date: | 1-Dec-2018 |
Publisher: | American Medical Association |
Abstract: | Importance: hypertriglyceridemia is the most frequent and limiting adverse effect of bexarotene therapy in cutaneous T-cell lymphoma (CTCL). Despite standard prophylactic measures, there is a wide variability in the severity of this complication, which could be associated with both genetic and environmental factors. Objectives: to analyze the association between genetic polymorphisms of apolipoprotein genes APOA5, APOC3, and APOE and the severity of hypertriglyceridemia during bexarotene therapy and to optimize patient selection for bexarotene therapy based on adverse effect profile. Design, Setting, and Participants: this case series study was conducted in 12 university referral hospitals in Spain from September 17, 2014, to February 6, 2015. One hundred twenty-five patients with a confirmed diagnosis of CTCL who had received bexarotene therapy for at least 3 months were enrolled. Nine patients were excluded owing to missing analytic triglyceride level data, leaving a study group of 116 patients. Data on demographic and cardiovascular risk factor were collected, and a complete blood analysis, including lipid profile and genetic analysis from a saliva sample, was performed. Main Outcomes and Measures: primary outcomes were the maximal triglyceride levels reported in association with the minor alleles of the polymorphisms studied. Results: among 116 patients, the mean (SD) age was 61.2 (14.7) years, 69 (59.5%) were men, and 85 (73.2%) had mycosis fungoides, the most prevalent form of CTCL. During bexarotene therapy, 96 patients (82.7%) experienced hypertriglyceridemia, which was severe or extreme in 8 of these patients (8.3%). Patients who carried minor alleles of the polymorphisms did not show significant differences in baseline triglyceride concentrations. After bexarotene treatment, carriers of at least 1 of the 2 minor alleles of APOA5 c.-1131T>C and APOC3 c.*40C>G showed lower levels of triglycerides than noncarriers (mean [SD], 241.59 [169.91] vs 330.97 [169.03] mg/dL, respectively; P = .02). Conclusions and Relevance: these results indicate that the screening of APOA5 and APOC3 genotypes may be useful to estimate changes in triglyceride concentrations during bexarotene treatment in patients with CTCL and also to identify the best candidates for bexarotene therapy based on the expected adverse effect profile. |
Note: | Reproducció del document publicat a: https://doi.org/10.1001/jamadermatol.2018.3679 |
It is part of: | JAMA Dermatology, 2018, vol. 154, num. 12, p. 1424-1431 |
URI: | http://hdl.handle.net/2445/127512 |
Related resource: | https://doi.org/10.1001/jamadermatol.2018.3679 |
ISSN: | 2168-6068 |
Appears in Collections: | Articles publicats en revistes (IDIBAPS: Institut d'investigacions Biomèdiques August Pi i Sunyer) Articles publicats en revistes (Ciències Clíniques) Articles publicats en revistes (Medicina) Articles publicats en revistes (Institut d'lnvestigació Biomèdica de Bellvitge (IDIBELL)) |
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