From the Research
No, ribociclib does not increase creatinine clearance in patients with impaired renal function. In fact, ribociclib can actually cause increases in serum creatinine levels, which indicates a decrease in creatinine clearance. This CDK4/6 inhibitor, used primarily for hormone receptor-positive, HER2-negative advanced breast cancer, can cause mild to moderate elevations in serum creatinine through inhibition of renal tubular secretion transporters rather than through actual kidney damage.
Key Points to Consider
- For patients with pre-existing mild or moderate renal impairment (creatinine clearance 30-89 mL/min), no dose adjustment is typically required, as shown in a study published in 2023 1.
- However, for severe renal impairment (creatinine clearance <30 mL/min), a reduced starting dose of 200 mg once daily is recommended instead of the standard 600 mg daily dose.
- Regular monitoring of renal function is important during ribociclib treatment, especially in patients with pre-existing kidney issues, as highlighted in a 2024 study 2.
- The effect on creatinine is generally reversible upon dose reduction or discontinuation of the medication, as demonstrated in various studies, including one published in 2021 3 and another in 2022 4.
- It's also important to consider potential drug-drug interactions, such as with metformin, which can increase the risk of lactic acidosis in patients with pre-existing renal impairment, as reported in a case study from 2022 4.
- A population pharmacokinetic and pharmacokinetic/pharmacodynamic analysis of ribociclib in cancer patients found that ribociclib's pharmacokinetics were not affected by mild or moderate renal impairment, supporting the use of standard dosing in these patients, as shown in a 2021 study 5.