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EHA 2021 | Cardiac toxicities associated with BTK inhibitor treatment

Lydia Scarfò, MD, Vita-Salute San Raffaele University & IRCCS San Raffaele Scientific Institute, Milan, Italy, discussess cardiovascular adverse events associated with ibrutinib therapy. Dr Scarfò comments on the occurrence of hypertension and reports that atrial fibrillation occurs in about 10% of patients, with risk factors including male gender, older age, diabetes and chronic obstructive pulmonary disease. Dr Scarfò also reports that cardiac toxicities are more pronounced in patients receiving ibrutinib due to its wider inhibition of kinases other than BTK. This interview took place at the virtual European Hematology Association (EHA) Congress 2021.

Transcript (edited for clarity)

As mentioned actually, in the trials, starting treatment with ibrutinib, some cardiovascular adverse events emerge. The potential occurrence of hypertension and the occurrence in about 10% of patients of atrial fibrillations. Different groups have tried identified patients at higher risk of these adverse events. In general, it seems that risk factors are applicable to the general population, meaning male gender, older age, hypertension, diabetes, chronic obstructive pulmonary disease, are more or less the same risk factors for the occurrence of atrial fibrillation in patients treated with ibrutinib...

As mentioned actually, in the trials, starting treatment with ibrutinib, some cardiovascular adverse events emerge. The potential occurrence of hypertension and the occurrence in about 10% of patients of atrial fibrillations. Different groups have tried identified patients at higher risk of these adverse events. In general, it seems that risk factors are applicable to the general population, meaning male gender, older age, hypertension, diabetes, chronic obstructive pulmonary disease, are more or less the same risk factors for the occurrence of atrial fibrillation in patients treated with ibrutinib.

It seems that this effect is more pronounced with ibrutinib because of the wider, let’s say inhibition, not only targeting BTK, but also involving other kinases. So, it should be less probable with more targeted agents. The same actually applies to hemorrhagic event, bleeding events, that were also associated with ibrutinib treatment. In most cases, some bleeding events are mild, so, basically, grade one or two according to the classification for adverse events most widely applied. But they are even less frequent in grade, in frequency with a novel BTK inhibitor.

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Disclosures

Lydia Scarfo, MD, has participated in advisory boards with AbbVie and Janssen and in educational activities with AstraZeneca.