Niraparib induces hyperglycaemia in ovarian cancer patients - is there any influence of BMI?

Background Niraparib (Nir) is a poly(ADP-ribose) polymerase inhibitor used in the maintenance treatment of platinum-sensitive ovarian cancer (OC) patients, regardless of homologous recombination deficiency status. Being overweight or obese increases the risk of developing both OC and diabetes. Given this overlap, understanding the effect of Nir on glycaemia is particularly important; however, it remains poorly understood. Methods The study included 22 normoglycaemic OC patients, who were either treated as one group or divided into two subgroups based on BMI: normal BMI (18.5–24.9 kg/m ² ; n=10) and elevated BMI (≥ 25 kg/m ² ; n=12). Fasting glucose (FG) concentrations were measured before therapy and after the second, third and fourth treatment cycle (a cycle is approximately 28 days). Two mixed models were applied to statistical calculations: one (1) categorised patients into BMI groups, while the other (2) treated BMI as a continuous variable. Results Impaired fasting glucose (5.6–6.9 mmol/L) was observed in 55% of patients at some point during the study, and in 27% throughout its duration. In model 1, a significant increase in glucose levels over time was observed (p = 0.0138). Neither BMI group nor its interaction with time was significant. In model 2, a significant interaction between BMI and time was detected (p = 0.0279), with the influence of BMI on Nir-caused hyperglycaemia increasing as the study progressed. Conclusions Hyperglycaemia appears to be adverse effects of Nir. There is some indication that this effect may be influenced by BMI, therefore glycaemic control is recommended, particularly in patients with elevated BMI.