TY - JOUR
T1 - Minimizing adverse side-effects of oral bexarotene in cutaneous T-cell lymphoma
T2 - An expert opinion
AU - Assaf, C.
AU - Bagot, M.
AU - Dummer, R.
AU - Duvic, M.
AU - Gniadecki, R.
AU - Knobler, R.
AU - Ranki, A.
AU - Schwandt, P.
AU - Whittaker, S.
PY - 2006/8
Y1 - 2006/8
N2 - Bexarotene is an oral retinoid therapy that is effective for the treatment of early and advanced-stage cutaneous T-cell lymphoma (CTCL) in patients who have failed on other therapies. However, bexarotene treatment is associated with un-avoidable side-effects, in particular hypertriglyceridaemia and hypothyroidism, which are manageable with adequate concomitant medications and are reversible on cessation of treatment. A pragmatic strategy for minimizing bexarotene-associated hypertriglyceridaemia and hypothyroidism is suggested, based on data from the studies with bexarotene in CTCL and on day-to-day experience with this agent in the clinical setting. The strategy anticipates that these common adverse events are likely to occur and recommends the early use of preventive therapy to lower triglycerides and elevate thyroid hormone levels in the blood, followed by subsequent monitoring, dose adjustment during bexarotene treatment, and titration of the daily bexarotene dose from 150 to 300 mg m-2, which is optimal for most patients. When further information becomes available on how bexarotene interacts with lipid metabolism and thyroid function, the management approach suggested here may need to be changed.
AB - Bexarotene is an oral retinoid therapy that is effective for the treatment of early and advanced-stage cutaneous T-cell lymphoma (CTCL) in patients who have failed on other therapies. However, bexarotene treatment is associated with un-avoidable side-effects, in particular hypertriglyceridaemia and hypothyroidism, which are manageable with adequate concomitant medications and are reversible on cessation of treatment. A pragmatic strategy for minimizing bexarotene-associated hypertriglyceridaemia and hypothyroidism is suggested, based on data from the studies with bexarotene in CTCL and on day-to-day experience with this agent in the clinical setting. The strategy anticipates that these common adverse events are likely to occur and recommends the early use of preventive therapy to lower triglycerides and elevate thyroid hormone levels in the blood, followed by subsequent monitoring, dose adjustment during bexarotene treatment, and titration of the daily bexarotene dose from 150 to 300 mg m-2, which is optimal for most patients. When further information becomes available on how bexarotene interacts with lipid metabolism and thyroid function, the management approach suggested here may need to be changed.
KW - Bexarotene
KW - Cutaneous T-cell lymphoma
KW - Hypertriglyceridaemia
KW - Hypothyroidism
KW - Rexinoid
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U2 - 10.1111/j.1365-2133.2006.07329.x
DO - 10.1111/j.1365-2133.2006.07329.x
M3 - Review article
C2 - 16882161
AN - SCOPUS:33745913350
SN - 0007-0963
VL - 155
SP - 261
EP - 266
JO - British Journal of Dermatology
JF - British Journal of Dermatology
IS - 2
ER -