Abstract

Tyrosine kinase inhibitors (TKIs) are widely used in the treatment of hematologic malignancies. Limited studies have shown an association between treatment-limiting arrhythmias and TKI, particularly ibrutinib, a Bruton's tyrosine kinase (BTK) inhibitor. We sought to comprehensively assess the arrhythmia burden in patients receiving ibrutinib vs non-BTK TKI vs non-TKI therapies.We performed a retrospective analysis of consecutive patients who received long-term cardiac event monitors while on ibrutinib, non-BTK TKIs, or non-TKI therapy for a hematologic malignancy between 2014 and 2022.One hundred ninety-three patients with hematologic malignancies were included (ibrutinib?=?72, non-BTK TKI?=?46, non-TKI therapy?=?75). The average duration of TKI therapy was 32 months in the ibrutinib group vs 64 months in the non-BTK TKI group (p?=?0.003). The ibrutinib group had a higher prevalence of atrial fibrillation (n?=?32 [44%]) compared to the non-BTK TKI (n?=?7 [15%], p?=?0.001) and non-TKI (n?=?15 [20%], p?=?0.002) groups. Similarly, the prevalence of non-sustained ventricular tachycardia was higher in the ibrutinib group (n?=?31, 43%) than the non-BTK TKI (n?=?8 [17%], p?=?0.004) and non-TKI groups (n?=?20 [27%], p?=?0.04). TKI therapy was held in 25% (n?=?18) of patients on ibrutinib vs 4% (n?=?2) on non-BTK TKIs (p?=?0.005) secondary to arrhythmias.In this large retrospective analysis of patients with hematologic malignancies, patients receiving ibrutinib had a higher prevalence of atrial and ventricular arrhythmias compared to those receiving other TKI, with a higher rate of treatment interruption due to arrhythmias.

View details for DOI 10.1007/s10840-023-01575-z

View details for PubMedID 37256462