Real-world cardiovascular safety profile of bexarotene for the treatment of mycosis fungoides.

Authors

Charalampos Filippatos, Despina Fotiou, Peggy Kostakou, Maria Gavriatopoulou, Evangelos Terpos, Meletios-Athanasios Dimopoulos, Alexandros Briasoulis

Published in

Clinical and experimental medicine. Volume 26. Issue 1. Aug 10, 2026. Epub Aug 10, 2026.

Abstract

Bexarotene has been established as an effective therapeutic agent for mycosis fungoides (MF), both in early, refractory disease and in advanced stages. It has a predictable, albeit significant, metabolic toxicity profile, raising concerns regarding long-term cardiovascular safety. We conducted a retrospective cohort study utilizing TriNetX to identify adults with MF. Patients were stratified by bexarotene exposure and 1:1 propensity score matched (PSM) for demographics, lifestyle factors, comorbidities, and baseline medications. After PSM, two well-balanced cohorts of 2,242 patients each were formed with a median follow-up of 4.0 years for both groups. Bexarotene treatment demonstrated no significant increase in the risk of the composite adapted-MACE endpoint (HR = 0.93, 95% CI: 0.78-1.11, p = 0.425). Similarly, no significant differences were observed for individual cardiovascular components, including acute myocardial infarction (HR = 0.95, p = 0.730), stroke (HR = 0.90, p = 0.514), or heart failure (HR = 0.93, p = 0.455). Conversely, bexarotene was associated with a significantly increased risk of metabolic and endocrine abnormalities, including hypertriglyceridemia (RR = 6.98, p < 0.001), hypothyroidism (RR = 4.93, p < 0.001), hyperlipidemia (RR = 2.18, p < 0.001), and hypercholesterolemia (RR = 1.99, p < 0.001). In the largest real-world cohort of MF patients treated with bexarotene to date, the substantial metabolic and endocrine abnormalities associated with treatment did not translate into an observed increase in cardiovascular events during a median follow-up of 4 years. These findings provide reassurance regarding the short- to intermediate-term cardiovascular profile of bexarotene when appropriate monitoring and management of lipid and thyroid abnormalities are maintained. However, longer follow-up is required to determine whether these metabolic effects influence long-term cardiovascular risk.

PMID:
42576057
Bibliographic data and abstract were imported from PubMed on 11 Aug 2026.

Read full publication at:
Please sign in to see all details.

Stats

1-terrible, 9-excellent. How would you rate this publication? Sign in in to submit your rating.

Post a comment

You need to be signed in to post comments. You can sign in here.

Comments

There are no comments yet.