2459 - Does bevacizumab increase joint pain ? Preliminary results of BEVARTHRALGIA Study

Background

Arthralgia and myalgia are described with the vascular endothelial growth factor inhibitor Bevacizumab (Bev). However, in clinical practice these pains are not spontaneously reported by patients. We aimed to evaluate the frequency of arthralgia in patients treated by Bev and identify risk factors associated with arthralgia.

Methods

We conducted an observational, prospective, bicentric, health data study in two French centers. Self-administered questionnaires were distributed to patients at the initiation of Bev, at 3 months and at 6 months during treatment. We included patients treated for ovarian, colorectal or lung cancers. Bev (5 to 15 mg/kg) was administered intravenously every 2 or 3 weeks with chemotherapy most of the time.

Results

We included 71 patients from January 2018 to November 2018 (42 patients with colorectal cancer, 22 with ovarian cancer and 7 with lung cancer). Seventy-one patients completed the questionnaire at initiation, 56 (78,9%) at 3 months and 36 (50,7%) at 6 months. The frequency of joint pain before Bev initiation was 29,6% and increase at 3 months (41,8%, p = 0,18) and significantly at 6 months (50%, p = 0,04). The functional repercussion significantly increased for elementary activities from 5,9% at initiation to 12,7% at 3 months (p < 0,001) and to 16,7% at 6 months (p < 0,001). There was no difference for instrumental activities at 3 months (p = 0,07) and at 6 months (p = 0,07). In univariate analysis, the frequency of arthralgia increased significantly at 3 months for patients with Body Mass Index (BMI) > 25 kg/m2 (p = 0,04), ovarian cancer (p < 0,001), chemotherapy with Carboplatin (p = 0,01) and Paclitaxel (p < 0,001), 15 mg/kg dose of Bev (p < 0,001). At 6 months, women (p = 0,03), chemotherapy with carboplatin (p < 0,001) and paclitaxel (p < 0,001), 15 mg/kg dose of Bev (p < 0,001) were significantly associated with arthralgia occurrence. Nineteen patients (26,8%) wished to consult a rheumatologist.

Conclusions

Bevacizumab-associated protocols are responsible for a significant increase of arthralgia frequency in women treated for an ovarian cancer. The pain appears in the first 3 months and increase during treatment. Oncologists should be aware of this side effect in order to inform the patients and propose a suitable treatment.

Clinical trial identification

NCT03455907.

Editorial acknowledgement

Legal entity responsible for the study

Vieillard Marie-Hélène.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.