Bilateral cystoid macular edema in a patient with chronic lymphocytic leukemia treated with ibrutinib

Viteri, Manuel Sáenz de; Cudrnak, Tomas

doi:10.1080/10428194.2018.1508673

Cited by 12 publications

(10 citation statements)

References 10 publications

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“… 7 , 8 Ibrutinib also has known ocular adverse effects, including red/dry eyes, subconjunctival haemorrhage, branch retinal artery occlusion and cystoid macular oedema. 9 , 10 …”

Section: Discussionmentioning

confidence: 99%

Ibrutinib-related uveitis: A case series

Chiu

Goh

Ling

et al. 2022

American Journal of Ophthalmology Case Reports

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Purpose Four cases of ibrutinib-related uveitis are presented, which are to the best of our knowledge the first in the literature. Possible mechanisms of ibrutinib-mediated uveitis are explored. Observations Case 1 is a 60-year-old female who had been stable on 1 year of ibrutinib for chronic lymphocytic leukaemia. She was diagnosed with ibrutinib-related uveitis, which responded well to topical steroids. Case 2 is a 63-year-old male diagnosed with uveitis after 2 years of ibrutinib treatment for chronic lymphocytic leukaemia. He responded well to topical and oral steroids; however, he continued to have uveitis relapses after weaning steroids. Case 3 is a 69-year-old male diagnosed with uveitis after 18 months of ibrutinib treatment. He was trialed on topical and intravenous steroids, and restarted ibrutinib without worsening of symptoms. Case 4 is a 66-year-old female who developed uveitis after being stable on ibrutinib for 3 years. She responded well to topical steroids. Conclusions and Importance Inflammatory complications of tyrosine kinase inhibitors are well described. While ibrutinib, and other kinase inhibitors, are generally well-tolerated, there are increasing reports of ocular toxicities, including uveitis. It is recommended to monitor patients for potential ocular adverse effects and facilitate rapid ophthalmologic assessment.

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“… 7 , 8 Ibrutinib also has known ocular adverse effects, including red/dry eyes, subconjunctival haemorrhage, branch retinal artery occlusion and cystoid macular oedema. 9 , 10 …”

Section: Discussionmentioning

confidence: 99%

Ibrutinib-related uveitis: A case series

Chiu

Goh

Ling

et al. 2022

American Journal of Ophthalmology Case Reports

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“…Cystoid macular edema secondary to Ibrutinib treatment, however, has been described previously in only two cases. Saenz-de-Viteri et al 13 reported on a 67-year-old man with relapsing CLL presenting with bilateral CME under treatment with 420 mg/day of Ibrutinib. After six weeks of topical treatment with dexamethasone 0.1% and ketorolac, complete resolution of CME was reported.…”

Section: Discussionmentioning

confidence: 99%

“…In addition, macular edema was reported as early as 4 weeks after treatment commencement. 13 While being diagnosed at an early phase – CME improved solely under local treatment, with no accompanying Ibrutinib cessation. No relapse within one year of follow up was reported, even after discontinuous topical treatment.…”

Section: Discussionmentioning

confidence: 99%

Cystoid macular edema secondary to ibrutinib

Ben-Avi

Dori

Chowers

2022

American Journal of Ophthalmology Case Reports

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“…Selective pressure for Th1-mediated immunity has been proposed as a mechanism for ibrutinib-associated uveitis (Mehraban Far et al, 2021). Concerning retinal disorders, only macular edema has been previously reported with ibrutinib (Saenz- de-Viteri and Cudrnak, 2018;Mirgh et al, 2020). It is noteworthy that ibrutinib can penetrate the blood-brain barrier in mantle cell lymphoma patients (Bernard et al, 2015) and therefore reach the retina by passing through the blood-retinal barrier.…”

Section: Potential Safety Signalsmentioning

confidence: 99%

Safety Profile of Ibrutinib: An Analysis of the WHO Pharmacovigilance Database

et al. 2021

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As ibrutinib has become a standard of care in B-cell malignancies in monotherapy or in combination with other agents, definition of its safety profile appears essential. The aim of this study was to further characterize the safety profile of ibrutinib through the identification of potential safety signals in a large-scale pharmacovigilance database. All serious individual case safety reports (ICSRs) in patients aged ≥18 years involving ibrutinib suspected in the occurrence of serious adverse drug reactions or drug interacting from November 13th, 2013 to December 31st, 2020 were extracted from VigiBase, the World Health Organization global safety database. Disproportionality reporting was assessed using the information component (IC) and the proportional reporting ratio (PRR), with all other anticancer drugs used as the reference group. To mitigate the confounding of age, two subgroups were considered: patients aged<75 years and ≥75 years. A signal of disproportionate reporting (SDR) was defined if both IC and PRR were significant. A total of 16,196 ICSRs were included. The median age of patients was 72.9 years, 42.6% of ICSRs concerned patients aged ≥75 years, and 64.2% male patients. More than half (56.2%) of ICSRs resulted in hospitalization or prolonged hospitalization. Among 713 SDRs, 36 potential safety signals emerged in ibrutinib-treated patients, mainly ischemic heart diseases, pericarditis, uveitis, retinal disorders and fractures. All potential safety signals having arisen in this analysis may support patient care and monitoring of ongoing clinical trials. However, owing to the mandatory limitations of this study, our results need further confirmation using population-based studies.

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Bilateral cystoid macular edema in a patient with chronic lymphocytic leukemia treated with ibrutinib

Cited by 12 publications

References 10 publications

Ibrutinib-related uveitis: A case series

Ibrutinib-related uveitis: A case series

Cystoid macular edema secondary to ibrutinib

Safety Profile of Ibrutinib: An Analysis of the WHO Pharmacovigilance Database

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