Body mass index affects imatinib exposure: Real‐world evidence from TDM with adaptive dosing
2025

Body mass index affects imatinib exposure

Sample size: 60 publication 10 minutes Evidence: moderate

Author Information

Author(s): Maroselli Paul, Fanciullino Raphaelle, Colle Julien, Farnault Laure, Roche Pauline, Venton Geoffroy, Costello Régis, Ciccolini Joseph

Primary Institution: La Conception University Hospital of Marseille

Hypothesis

Does body mass index (BMI) influence imatinib pharmacokinetics in CML patients?

Conclusion

Low BMI significantly impacts imatinib exposure, but pharmacokinetically-guided dosing mitigates its clinical effects.

Supporting Evidence

  • Only 29% of patients were in the therapeutic range for imatinib.
  • Patients with BMI < 18.5 kg/m2 had significantly higher imatinib levels.
  • Adaptive dosing was implemented for 74% of patients based on TDM results.
  • No difference in toxicity or efficacy was observed after adaptive dosing.
  • Mean trough levels were 994.2 ± 560.6 ng/ml at treatment initiation.

Takeaway

If you're small, the medicine might hit you harder, but doctors can adjust the dose to keep you safe.

Methodology

This was a retrospective, non‐interventional, observational study using therapeutic drug monitoring (TDM) and adaptive dosing in CML patients.

Potential Biases

Potential bias due to the retrospective nature and lack of longitudinal TDM after dose adjustments.

Limitations

The study was limited by the small sample size and the single-institution setting.

Participant Demographics

Mean age 56 years, 33 males and 27 females.

Statistical Information

P-Value

0.018

Statistical Significance

p<0.05

Digital Object Identifier (DOI)

10.1111/fcp.13049

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