A popular cancer drug is associated with significant weight gain and increased systolic blood pressure, researchers from the Icahn School of Medicine at Mount Sinai report in a study published in Scientific Reports in November.
The drug, ruxolitinib, was the first and currently remains the most widely used FDA-approved mechanism-based therapy for myeloproliferative neoplasms (MPNs), blood cancers that include myelofibrosis and polycythemia vera. Ruxolitinib is a Janus kinases (JAK) 1/2 inhibitor, an enzyme-blocker that affects blood cell production.
As cancer therapies improve, and patients are living longer on them, understanding the long-term consequences of these targeted therapies on metabolic health is increasingly important.
"Weight gain with ruxolitinib has previously been reported in clinical trials, but our study provides real-world experience regarding the extent of that weight gain," said Emily J. Gallagher, MD, PhD, the study's lead author and Assistant Professor of Medicine (Endocrinology, Diabetes and Bone Disease) at the Icahn School of Medicine at Mount Sinai, specializing in onco-endocrinology, the treatment of endocrine complications of oncology treatments. "We recommend that patients who go on this medication and do have an increase in weight get a full metabolic evaluation."
The researchers studied 69 patients with MPNs who started on ruxolitinib from 2010 to 2017 at Mount Sinai. The patients' medical records had data on metabolic parameters up to one year prior to starting ruxolitinib and 72 weeks after starting the drug. They found that more than half of patients taking this medication gained more than 5 percent in body weight. The weight gain was also associated with an increase in systolic blood pressure and liver enzymes.
"In contrast to the perception of many health care providers, patients are not going from being underweight to being a normal weight. Instead, a significant number of patients are developing obesity. Based on these results, physicians should be aware of the potential effects, and counsel patients accordingly," said Dr. Gallagher.
This study is the first step in documenting the metabolic consequences of this drug. Further studies are needed to gain a greater understanding of the changes in hormones and metabolism in those receiving treatment for this condition.
About the Mount Sinai Health System
The Mount Sinai Health System is New York City's largest integrated delivery system, encompassing eight hospitals, a leading medical school, and a vast network of ambulatory practices throughout the greater New York region. Mount Sinai's vision is to produce the safest care, the highest quality, the highest satisfaction, the best access and the best value of any health system in the nation. The Health System includes approximately 7,480 primary and specialty care physicians; 11 joint-venture ambulatory surgery centers; more than 410 ambulatory practices throughout the five boroughs of New York City, Westchester, Long Island, and Florida; and 31 affiliated community health centers. The Icahn School of Medicine is one of three medical schools that have earned distinction by multiple indicators: ranked in the top 20 by U.S. News & World Report's "Best Medical Schools", aligned with a U.S. News & World Report's "Honor Roll" Hospital, No. 12 in the nation for National Institutes of Health funding, and among the top 10 most innovative research institutions as ranked by the journal Nature in its Nature Innovation Index. This reflects a special level of excellence in education, clinical practice, and research. The Mount Sinai Hospital is ranked No. 14 on U.S. News & World Report's "Honor Roll" of top U.S. hospitals; it is one of the nation's top 20 hospitals in Cardiology/Heart Surgery, Diabetes/Endocrinology, Gastroenterology/GI Surgery, Geriatrics, Gynecology, Nephrology, Neurology/Neurosurgery, and Orthopedics in the 2019-2020 "Best Hospitals" issue. Mount Sinai's Kravis Children's Hospital also is ranked nationally in five out of ten pediatric specialties by U.S. News & World Report. The New York Eye and Ear Infirmary of Mount Sinai is ranked 12th nationally for Ophthalmology and Mount Sinai South Nassau is ranked 35th nationally for Urology. Mount Sinai Beth Israel, Mount Sinai St. Luke's, Mount Sinai West, and Mount Sinai South Nassau are ranked regionally.
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