Abstract
To clarify the association between carboplatin and electrolyte abnormality, a pooled-analysis was performed with the adverse event reports of non-small cell lung cancer patients. A total of 19901 adverse events were retrieved from the FDA Adverse Event Reporting System (FAERS). Pooled reporting odds ratios (RORs) and 95% CIs suggested that carboplatin was significantly associated with hyponatremia (pooled ROR = 1.57, 95% CI 1.182.09, P = 1.99 × 10-3) and hypokalemia (pooled ROR = 2.37, 95% CI 1.803.10, P = 5.24 × 10-10) as compared to other therapies. In addition, we found that dehydration was frequently concurrent with carboplatin therapy (pooled ROR = 2.01, 95% CI 1.522.66, P = 8.37 × 10-7), which may prompt excessive water ingestion and decrease serum electrolyte concentrations. This information has not been mentioned in the FDA-approved drug label and could help explain the physiological mechanism of carboplatin-induced electrolyte abnormality. In conclusion, the above results will facilitate clinical management and prompt intervention of life-threatening electrolyte imbalance in the course of cancer treatment.
Highlights
Drug-induced electrolyte abnormality has been widely observed in hospitalized patients [1, 2]
By comparing the patients exposed to carboplatin and other drugs, we examined whether hyponatremia and hypokalemia were significantly more concurrent with carboplatin therapy, so as to understand the effects of carboplatin on serum electrolyte levels
The pooled analysis on hyponatremia involved a total of 19901 adverse event reports, among which 3907 reports (19.63%) were related to patients exposed to carboplatin
Summary
Drug-induced electrolyte abnormality has been widely observed in hospitalized patients [1, 2]. Hyponatremia (defined as serum sodium concentration lower than 135 mmol/L) and hypokalemia (defined as serum potassium concentration lower than 3.5 mmol/L) are two of the most common forms of electrolyte abnormality. Electrolyte abnormality is found to cause various symptoms and to be associated with negative consequences regarding morbidity and mortality [3, 4]. In the course of treatment with specific drugs, electrolyte abnormality may develop either symptomatically or asymptomatically [5]. Since it is difficult for clinicians to pay constant attention to drug reactions, drug-induced electrolyte abnormality may be underdiagnosed in some cases. Thorough awareness of the adverse effects of certain drugs on serum sodium and potassium levels is of great importance for effective prevention of potentially life-threatening electrolyte disturbance
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