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Tandem Meetings 2026 | Considering cardiovascular comorbidities when using BTK inhibitors for B-cell malignancies
In this video, Krish Patel, MD, Sarah Cannon Research Institute, Nashville, TN, briefly discusses the need for physicians to consider cardiovascular comorbidities when treating patients with B-cell malignancies with BTK inhibitors, given the cardiovascular toxicities associated with these agents. This interview took place virtually.
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Transcript
Yeah, I think one of the things now, I think many folks are comfortable using BTK inhibitors across the spectrum of B-cell malignancies, but it remains important to think about cardiovascular toxicities. We can safely use second-generation inhibitors in patients that have cardiovascular comorbidities, but things we want to pay attention to are atrial fibrillation. That isn’t a contraindication to the use of BTK inhibitors, but how well somebody’s afib, if they have that at baseline, is controlled is an important consideration...
Yeah, I think one of the things now, I think many folks are comfortable using BTK inhibitors across the spectrum of B-cell malignancies, but it remains important to think about cardiovascular toxicities. We can safely use second-generation inhibitors in patients that have cardiovascular comorbidities, but things we want to pay attention to are atrial fibrillation. That isn’t a contraindication to the use of BTK inhibitors, but how well somebody’s afib, if they have that at baseline, is controlled is an important consideration. I think certainly hypertension, which can be a delayed toxicity of BTK inhibitors, is something we need to think about and manage well. And then many of our patients that have cardiac comorbidities may be on medicines that increase bleeding risks like antiplatelets or anticoagulants. And so that is really something that we see as a class effect of BTK inhibitors. There may be some subtle differences between agents in terms of minor bleeding risks. Severe bleeding risks are fortunately low, but those are the things I typically try to focus on and optimize.
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