Evaluating the Safety of Combining Tyrosine Kinase Inhibitors with Anticoagulants in Chronic Myeloid Leukemia: A Systematic Review
Abstract
UNLABELLED: Introduction: The prognosis of chronic myeloid leukemia (CML) has been revolutionized in recent decades with tyrosine kinase inhibitors (TKIs). Yet, comorbidities that require anticoagulation therapy pose a challenge in CML management because of the scarcity of evidence on the optimal drug combinations. This systematic review (SR) aimed to summarize the efficacy and safety considerations for the concomitant use of anticoagulants with different TKIs in CML and investigate their potential drug interactions.
METHODS: A comprehensive search strategy was used, employing Medical Subject Headings and free-text terms across databases including PubMed (via OVID), Medline (via OVID), Embase (via OVID), and Web of Science. Members of the research team independently screened the titles and abstracts for eligibility based on predefined inclusion and exclusion criteria. Data extraction was then performed using a standardized form to record the studies' characteristics, the TKIs and anticoagulants used, and the safety outcomes. Two reviewers independently assessed study quality using the Critical Appraisal Skills Program (CASP) checklists and the Joanna Briggs Institute (JBI) tool for case reports.
RESULTS: The search yielded 406 studies, of which 13 met the inclusion criteria for reporting real-world safety data in adults receiving TKIs with anticoagulants. Overall, the combinations of TKIs with anticoagulants like ponatinib with apixaban and imatinib with warfarin had no…
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