ROLE OF DEXRAZOXANE IN THE PREVENTION OF CHEMOTHERAPY RELATED CARDIOTOXICITY: A SYSTEMATIC META-ANALYSIS REVIEW
Dr. Mohammed Safi-Ur-Rahman*, Dr. Afrah Rahman, Dr. Mohammed Ghazali, Dr. Rajesh Chalakalapalli, Dr. Sumaiya Tabassum and Dr. Anupama Koneru
ABSTRACT
Background: Cardiotoxicity is a well-recognized complication of chemotherapy with Anthracycline and its prevention remains an important challenge in cancer survivorship. Several successful preventative strategies have been identified in animal trials. This study sought to assemble the clinical evidence that prophylactic interventions with Dexrazoxane could prevent cardiotoxicity in patients undergoing Anthracycline chemotherapy. (Kalam, 2013). Methods: This is a meta-analysis of the evidence from randomized trials where Dexrazoxane was used as the prophylactic intervention and compared with a control arm in patients with a normal ejection fraction and no past history of heart failure. The primary outcome was development of heart failure (HF), a drop in ejection fraction (EF) or any other investigation that identifies cardiotoxicity. A random-effects model was used to combine odd‟s ratio (OR) and 95% confidence intervals (CI). Findings: Data were collated from 5 published articles (n = 914 pediatric and adult patients) comprising 5 randomized controlled trials. The most studied chemotherapeutic agent was Doxorubicin. The average odds of cardiotoxicity in presence of Dexrazoxane was found to be 0.251 (95% CI, 0.171-0.370 with P=0.000). Interpretation: Prophylactic therapy with Dexrazoxane was found to be effective in preventing cardiotoxicity caused by Anthracycline chemotherapy for cancer.
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