Table 7Summary of Findings by Outcome — Cardiac and Vascular Adverse Events

Outcome Gallois et al. (2022),13 NRSBatra et al. (2021),14 NRSKhan et al. (2018),15 NRSRansom et al. (2014),16 NRSKelly et al. (2013),12 SRKelly et al. (2013),12 NRS
Treated Control a
Number of patients3684 b15542NANR63
Patients who experienced cardiac events during raltitrexed therapy, n (%)008 (5.2)——0—
   Angina——3 (1.9)————
   Arrhythmia——3 (1.9)1 (2.4) c———
   Palpitations——1 (< 0.1)————
   Myocardial infarction——1 (< 0.1)————
Rate of cardiac events attributed to raltitrexed, % (95% CI)———0 (0 to 8.4)20% (NA)——
Patients who experienced cardiovascular or cerebrovascular events, n (%)——————3 (4.8)

CI = confidence interval; NA = not applicable; NR = not reported; NRS = non-randomized study; SR = systematic review.

Note: Reported number of patients and outcomes are based on the patient relevant to this report: i.e., patients who experienced serious adverse events (cardiac or non-cardiac) from fluoropyrimidine treatment.

a

The authors assumed a true rate of cardiac toxicity of 20%: “Current evidence suggests that the rate of cardiac events due to continuing FU [fluoropyrimidines] after initial cardiac event is at least 20%” (p.118).16

b

This study14 included 86 patients, but adverse outcomes were measured out of 84; it was not clearly reported why 2 patients were excluded from this analysis.

c

The reported outcome was cardiac toxicity specific to the raltitrexed treatment. One patient experienced arrhythmia; however, the arrhythmia was considered to be unrelated to the raltitrexed (with oxaliplatin) treatment.

From: Raltitrexed in Patients With Dihydropyrimidine Dehydrogenase Deficiency

Cover of Raltitrexed in Patients With Dihydropyrimidine Dehydrogenase Deficiency
Raltitrexed in Patients With Dihydropyrimidine Dehydrogenase Deficiency: Rapid Review [Internet].
Vu T, Spry C; Authors.
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