TY - JOUR
AB - The current study reports the case of an 80‑year‑old woman who experienced severe hypoglycaemia after abemaciclib administration, with a recovery time of ~46 h. Abemaciclib is a cyclin‑dependent kinase 4 and 6 (CDK4/6) inhibitor that is used to treat metastatic breast cancer. A side effect of abemaciclib administration is an increase in creatinine levels. The half‑life (t1/2) of 150 mg abemaciclib in patients with breast cancer was reported to be 17.5 h (nearly lower limit), and the time to reach Cmax was ~5 h (Tmax, 4‑6 h). Therefore, the total time to reach half the maximum blood concentration after abemaciclib administration is ~24 h (Tmax + t1/2=5+17.5=22.5 h). As abemaciclib is administered twice daily, a considerable amount (Cmax = 123 ng/ml) may persist in the blood following the initial dose. Upon repeated administration, the blood abemaciclib concentration in patients with metastatic liver tumours might increase, although their liver function remains normal. The patient described in the current study had a creatinine level of 1.05 mg/dl at the start of abemaciclib administration. At the time of emergency hospitalisation (on day 5 of abemaciclib administration), the creatinine level was 1.40 mg/dl; however, dehydration was not observed. The patient had been administered the same dose of glimepiride for >1 year and had not experienced hypoglycaemia previously. It can be speculated that the increase in blood creatinine level had some effect on glimepiride metabolism. It is thought that administered abemaciclib enhances metabolic delay in the blood in the same way as in patients with impaired liver function, and as a result, the creatinine level increases in patients with liver metastases. This causes a decrease in renal function, which in turn results in an increase in blood concentration of glimepiride, consequently leading to severe hypoglycaemia. Therefore, clinicians must be careful when using abemaciclib in patients with liver metastases, diabetes and poor renal function.
AD - Department of Pharmacy, Oda Municipal Hospital, Oda, Shimane 694‑0063, Japan
Department of General Medicine, Shimane University Faculty of Medicine, Oda General Medicine Education Center, Oda, Shimane 694‑0063, Japan
Department of Surgery, Oda Municipal Hospital, Oda, Shimane 694‑0063, Japan
AU - Horie,Tatsuo
AU - Kijima,Tsunetaka
AU - Yamaguchi,Minekazu
AU - Honda,Satoshi
AU - Horie,Miyako
AU - Ishitobi,Kazunari
AU - Yamagata,Shingo
AU - Sakano,Shigeru
AU - Kurokohchi,Kazutaka
DA - 2021/03/01
DO - 10.3892/mco.2021.2223
IS - 3
JO - Mol Clin Oncol
KW - abemaciclib
creatinine
cyclin‑dependent kinase 4 and 6
diabetes
protein‑binding
renal dysfunction
severe hypoglycaemia
PY - 2021
SN - 2049-9450
2049-9469
SP - 61
ST - Severe hypoglycaemia under abemaciclib administration in a patient with breast cancer: A case report
T2 - Molecular and Clinical Oncology
TI - Severe hypoglycaemia under abemaciclib administration in a patient with breast cancer: A case report
UR - https://doi.org/10.3892/mco.2021.2223
VL - 14
ER -