Evidence map›Paper›PMID 36051996›Full record

ArticleWorld journal of gastrointestinal endoscopy2022

Safety of endoscopy in patients undergoing treatments with antiangiogenic agents: A 5-year retrospective review.

Mohammad Azam, Amit Hudgi, Pearl Princess Uy, Jinal Makhija, John Erikson L Yap

Open access · diamondAbstract read
In one paragraph

Article in World journal of gastrointestinal endoscopy, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.5field-weighted citation impact, top 37% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 3 citations in OpenAlex.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors at 1 institution in 1 country.

Mohammad AzamDepartment of Internal Medicine, Medical College of Georgia/Augusta University, Augusta, GA 30912, United States.
Amit HudgiDepartment of Internal Medicine, Medical College of Georgia/Augusta University, Augusta, GA 30912, United States.
Pearl Princess UyDivision of Gastroenterology, Medical College of Georgia/Augusta University, Augusta, GA 30912, United States.
Jinal MakhijaDepartment of Internal Medicine, Rush University Medical Center, Chicago, IL 60612, United States.
John Erikson L YapDivision of Gastroenterology, Medical College of Georgia/Augusta University, Augusta, GA 30912, United States. jyap@augusta.edu.
Rush University Medical Center · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAntiangiogenic agents (AAs) are increasingly used to treat malignant tumors and have been associated with gastrointestinal (GI) bleeding and perforation. Elective surgeries and endoscopy are recommended to be delayed for 31 d until after AAs treatment. Data regarding the safety of endoscopy while on antiangiogenic agents is extremely limited. No guidelines are in place to address the concern about withholding these anti-angiogenic drugs.

aimTo evaluate the risks of endoscopy in patients on antiangiogenic agents from 2015 to 2020 at our institution.

methodsThis is a single centered retrospective study approved by the institutional review board statement of the institution. Patients that underwent endoscopy within 28 d of antiangiogenic agents' treatment were included in the study. Primary outcome of interest was death, and secondary outcomes included perforation and GI bleeding. Data were analyzed utilizing descriptive statistics. Fifty-nine patients were included in the final analysis and a total of eighty-five procedures were performed that were characterized as low risk and high risk.

resultsAmong the 59 patients a total of 85 endoscopic procedures were performed with 24 (28.2%) categorized as high-risk and 61 (71.8%) procedures as low-risk. Of the total number of patients, (50%) were on bevacizumab and the rest were on imatinib (11.7%), lenvatinib (6.7%) and, ramucirumab (5%). The average duration between administration of AAs and the performance of endoscopic procedures was 9.9 d. No procedure-related adverse events were noted among our study population. We did observe two deaths with one patient, on lenvatinib for metastatic hepatocellular carcinoma, who had persistent bleeding despite esophageal variceal banding and died 4 d later from hemorrhagic shock. Another patient was diagnosed with acute myeloid leukemia died 24 d after an esophagogastroduodenoscopy with biopsy after transition to comfort care.

conclusionAs per this single center retrospective study, the rate of endoscopic procedure-related adverse events and death within 28 d of AA administration appears to be low.

Indexed as

Adverse eventsAntiangiogenicsBevacizumabEndoscopyLenvatinibLmatinib

Identifiers

PMID36051996
PMCPMC9329849
OpenAlexW4284880815

What Socratic holds

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LicenceCC BY-NC
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.