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ICML 2021 | BTK inhibitor associated cardiac arrhythmias

Barbara Eichhorst, MD, University Hospital Cologne, Cologne, Germany, discusses the association between tachycardia and chronic lymphocytic leukemia (CLL) medication. Ibrutinib, a BTK inhibitor, can increase the risk of atrial fibrillation in approximately 10% of patients and death in rare cases. Alternative treatments including acalabrutinib or BCL2 inhibitors such as venetoclax with obinutuzumab can lower incidences of tachycardia. This is interview took place during the 2021 International Conference on Malignant Lymphoma (16-ICML).

Transcript (edited for clarity)

The tachycardia and or other previous cardiac co-morbidities may be a significant problem when the BTK inhibitor, ibrutinib is considered for treatment in those patients because we know inside and outside trials there, so around 10% incidence of atrial fibrillation.

Also much more rarely, but then frequently associated with significant morbidity and sometimes cause mortality, ventricular tachycardia and therefore the patient case we discussed what the case where you would consider really would like to consider ibrutinib or rather giving for example a newer, or more specifically binding BTK inhibitor as acalabrutinib...

The tachycardia and or other previous cardiac co-morbidities may be a significant problem when the BTK inhibitor, ibrutinib is considered for treatment in those patients because we know inside and outside trials there, so around 10% incidence of atrial fibrillation.

Also much more rarely, but then frequently associated with significant morbidity and sometimes cause mortality, ventricular tachycardia and therefore the patient case we discussed what the case where you would consider really would like to consider ibrutinib or rather giving for example a newer, or more specifically binding BTK inhibitor as acalabrutinib. And we have seen their data at the summer meetings and that acalabrutinib is associated with a significantly lower rate of atrial fibrillation.

Therefore in the end, we discussed that this could be an alternative option to a patient with tachycardia, of course decides that the completely different type of treatment, BCL-2 inhibitor, venetoclax in combination with obinutuzumab, could of course also be an option in a patient like that.

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