Analysis and Evaluation of Clinical Characteristics of Severe Hypertriglyceridemia Caused by Capecitabine
LIU Ying, ZHANG Yan-hua*
Key Laboratory of Carcinogenesis and Translational Research(Ministry of Education), Department of Pharmacy, Peking University Cancer Hospital and Institute, Beijing 100142
Abstract：OBJECTIVE To analyze the cases of severe hypertriglyceridemia caused by capecitabine reported in literature and found in our hospital, so as to understand the characteristics, prevention and intervention measures of this adverse reaction. METHODS Case reports of severe hypertriglyceridemia(HTG)caused by capecitabine were retrieved from PubMed and CMKI website database, and relevant information, such as patients′ basic information, capecitabine medication, triglyceride(TG)level,chronic disease,complication, lipid-lowering treatment, was extracted. Microsoft Excel 2013 was used to analyze the data. RESULTS Twenty-one cases of severe HTG(TG≥500 mg·dL-1) caused by capecitabine were reported in 14 literatures. A total of 23 cases were included in the analysis, including 2 cases found in our hospital. Among them, there were 10 males and 13 females. The mean age is (57.6±8.8)years. The TG level of 18 patients was grade 4, and that of 5 patients was grade 3. Twelve patients had basic diseases such as dyslipidemia, abnormal blood glucose or obesity; thirteen patients with hyperlipidemia were complicated with hypercholesterolemia, hyperglycemia or acute pancreatitis. Sixteen patients were treated with lipid-lowering drugs, including fibrates, statins and omega-3 fatty acids. After drug treatment, drug withdrawal and other interventions, the TG level of 19 patients decreased to below grade 2. CONCLUSION In clinical practice, attention should be paid to the effect of capecitabine on blood lipid metabolism, and the occurrence of severe hyperlipidemia should be vigilant. During capecitabine treatment, for patient with dyslipidemia, diabetes, obesity and other metabolic diseases, as well as menopausal women, blood lipid monitoring should be done to ensure the safety of patients.
刘颖, 张艳华. 卡培他滨导致严重高甘油三酯血症临床特点分析与评价[J]. 中国药学杂志, 2022, 57(22): 1942-1946.
LIU Ying, ZHANG Yan-hua. Analysis and Evaluation of Clinical Characteristics of Severe Hypertriglyceridemia Caused by Capecitabine. Chinese Pharmaceutical Journal, 2022, 57(22): 1942-1946.
U.S. Food & Drug Administration. XELODA (capecitabine) tablets . . https://www.accessdata.fda.gov/drugsatfda_docs/label/2019/020896Orig1s042lbl.pdf.
[2]
KOUTRAS A K,HABEOS I G,VAGENAKIS A G,et al. Capecitabine-induced hypertriglyceridemia: a report of two cases . Anticancer Res, 2006,26(3B):2249-2251.
[3]
KURT M,BABAOGLU MO,YASAR U,et al. Capecitabine-induced severe hypertriglyceridemia: report of two cases . Ann Pharmacother, 2006,40(2):328-331.
[4]
DUMAN B B,PAYDAS S,TETIKER T,et al. Capecitabine-induced hypertriglyceridemia and hyperglycemia: two cases . Pharmacology, 2012,90(3-4):212-215.
[5]
UCHE A,VANKINA R,GONG J,et al. Capecitabine-induced hypertriglyceridemia: a rare but clinically relevant treatment-related adverse event . J Gastrointest Oncol, 2018,9(6):1213-1219.
[6]
HAN G H,HUANG J X. Hypertriglyceridemia and hyperglycemia induced by capecitabine: a report of two cases and review of the literature . J Oncol Pharm Pract, 2015,21(5):380-383.
[7]
BAR-SELA G,COHENSIUS-KENT D,VORNIKOVA O,et al.Increase in triglyceride blood level in patients treated with capecitabine . Anticancer Drugs, 2014,25(6):729-734.
[8]
LEUNG J,BRADY J L,CROOK M A. The clinical importance of recognizing capecitabine-induced hypertriglyceridemia: A case report and review of the literature . J Clin Lipidol, 2018,12(6):1371-1373.
[9]
GARG R, ANGUS E,FINCHER S. Capecitabine-induced severe hypertriglyceridaemia and diabetes: a case report and review of the literature . Diabet Med, 2009,26(12):1308-1309.
[10]
BAR-SELA G,HAIM N. Uncontrolled hypertriglyceridemia induced by capecitabine: case report and review of the literature . Cancer Chemother Pharmacol, 2009,63(5):779-782.
[11]
ORPHANOS G S,STAVROU N G,PICOLOS M K. Hypertriglyceridemia: An underdiagnosed side effect of Capecitabine chemotherapy . Acta Oncol, 2010,49(2):262-263.
[12]
JAVOT L,SPAËTH D,SCALA-BERTOLA J,et al. Severe hypertriglyceridaemia during treatment with capecitabine . Br J Cancer, 2011,104(7):1238-1239.
[13]
POLINDER-BOS HA,KOK EE,VAN DE WIEL A,et al. Severe hypertriglyceridaemia associated with the use of capecitabine . Neth J Med, 2012,70(2):104.
[14]
STATHOPOULOS G P,KOUTANTOS J,LAZAKI H. Capecitabine(Xeloda)as monotherapy in advanced breast and colorectal cancer: effectiveness and side-effects . Anticancer Res, 2007,27(3B):1653-1656.
[15]
CHAN H Y,NG C M,TIU S C,et al. Hypertriglyceridaemia-induced pancreatitis: a contributory role of capecitabine? . Hong Kong Med J, 2012,18(6):526-529.
[16]
MICHIE C O,SAKALA M,RIVANS I,et al. The frequency and severity of capecitabine-induced hypertriglyceridaemia in routine clinical practice: a prospective study . Br J Cancer,2010, 103(5):617-621.
[17]
GEVA S,LAZAREV I,GEFFEN D B,et al. Hypertriglyceridemia in patients with metastatic breast cancer and treatment with capecitabine . J Chemother, 2013,25(3):176-180.
[18]
REINER Ž. Hypertriglyceridaemia and risk of coronary artery disease . Nat Rev Cardiol, 2017,14(7):401-411.
[19]
BERGLUND L,BRUNZELL J D,GOLDBERG A C,et al. Treatment options for hypertriglyceridemia: from risk reduction to pancreatitis . Best Pract Res Clin Endocrinol Metab, 2014,28(3):423-437.
[20]
JIANG Y,HE Q,LI S,et al. Reversible severe fatty liver induced by capecitabine: a case report. Medicine(Baltimore), 2017,96(46):e8547.
[21]
DAYSPRING T D. Understanding hypertriglyceridemia in women: clinical impact and management with prescription omega-3-acid ethyl esters . Int J Womens Health, 2011, 3:87-97.
[22]
ANAGNOSTIS P,BITZER J,CANO A,et al. Menopause symptom management in women with dyslipidemias: An EMAS clinical guide . Int J Womens Health, 2011, 3:87-97.
[23]
MORABIA A,COSTANZA MC. International variability in ages at menarche, first livebirth, and menopause. World Health Organization Collaborative Study of Neoplasia and Steroid Contraceptives. Am J Epidemiol, 1998,148(12):1195-1205.
[24]
SIMHA V. Management of hypertriglyceridemia . BMJ, 2020,371:m3109.
[25]
PARHOFER K G,LAUFS U. The diagnosis and treatment of hypertriglyceridemia . Dtsch Arztebl Int, 2019,116(49):825-832.
2022, Vol. 57 
