How to Manage Atrial Fibrillation Secondary to Ibrutinib

Essa, Hani; Lodhi, Taha; Dobson, Rebecca; Wright, David J.; Lip, Gregory Y. H.

doi:10.1016/j.jaccao.2020.11.016

Cited by 19 publications

(16 citation statements)

References 8 publications

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“…Nevertheless, previous studies have shown that BTKi-related AF can be successfully managed in real-world clinical practice by dose reduction as well as rhythm and rate control strategies, and thus may not result in treatment discontinuation. [47][48][49][50] It should also be noted that oncology outcomes such as PFS and overall response were not captured in the Flatiron Health database.…”

Section: Discussionmentioning

confidence: 99%

Real-World Persistence and Time to Next Treatment With Ibrutinib in Patients With Chronic Lymphocytic Leukemia/Small Lymphocytic Lymphoma Including Patients at High Risk for Atrial Fibrillation or Stroke

Narezkina¹,

Akhter²,

Lu³

et al. 2022

Clinical Lymphoma Myeloma and Leukemia

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Section: Discussionmentioning

confidence: 99%

Real-World Persistence and Time to Next Treatment With Ibrutinib in Patients With Chronic Lymphocytic Leukemia/Small Lymphocytic Lymphoma Including Patients at High Risk for Atrial Fibrillation or Stroke

Narezkina¹,

Akhter²,

Lu³

et al. 2022

Clinical Lymphoma Myeloma and Leukemia

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“…Digoxin also interacts with ibrutinib through P-glycoprotein interactions and therefore should be avoided when possible. 70 With respect to anticoagulation, the decision is made based on clotting risk (CHA2DS2-Vasc score) and bleeding risk (HAS-BLED score), similarly to management in patients who are not being treated with a BTK inhibitor. The bleeding risk associated with BTK inhibitors should be considered as well.…”

Section: Managing Toxicities Of Btk Inhibitorsmentioning

confidence: 99%

Use of BTK Inhibitors in Chronic Lymphocytic Leukemia/Small Lymphocytic Lymphoma (CLL/SLL): A Practical Guidance

St‐Pierre¹,

Ma²

2022

BLCTT

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The treatment landscape of chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL) has changed significantly since the development of oral Bruton’s tyrosine kinase (BTK) inhibitors. While chemoimmunotherapy was previously the standard of care for first-line treatment, BTK inhibitors have proven to be a highly effective and safe therapeutic option for CLL/SLL, and now constitute one of the preferred first-line options. Ibrutinib, the first approved covalent BTK inhibitor in CLL/SLL, has the most long-term data supporting its efficacy in CLL/SLL treatment although is associated with increased risk of cardiovascular and hemorrhage adverse events due to off-target kinase inhibition. The second-generation covalent BTK inhibitors, including acalabrutinib and zanubrutinib, are more selective to BTK with less off-target effects. Resistance to covalent BTK inhibitors may emerge over time due to mutations in BTK and downstream kinases. Novel non-covalent BTK inhibitors currently being studied are showing promising activities to overcome such resistance. In this review, we discuss the role of BTK inhibitors in treatment of CLL/SLL, review the data that led to approval of BTK inhibitors in CLL/SLL, outline the toxicity profile of each approved BTK inhibitor and management, and give practical guidance on how to select the most appropriate agent for treatment.

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“…[ 38 ] Cardio-oncology can also facilitate the use of lower doses of DOACs in patients at high risk of bleeding or a reduced dose of BTK inhibitors to reduce the burden of AF in conjunction with oncology and a multidisciplinary team approach. [ 39 ]…”

Section: Special Situations In Cardio-oncologymentioning

confidence: 99%

Palpitations in the Cancer Patient

Essa

Lip

2021

Eur Cardiol

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Cancer and cardiovascular diseases (CVD) are among the leading causes of death worldwide. In response to the growing population of cancer patients and survivors with CVD, the sub-specialty of cardio-oncology has been developed to better optimise their care. Palpitations are one of the most common presenting complaints seen in the emergency room or by the primary care provider or cardiologist. Palpitations are defined as a rapid pulsation or abnormally rapid or irregular beating of the heart and present a complex diagnostic entity with no evidence-based guidelines currently available. Palpitations are a frequent occurrence in people with cancer, and investigations and treatment are comparable to that in the general population although there are some nuances. Cancer patients are at a higher risk of arrhythmogenic causes of palpitations and non-arrhythmogenic causes of palpitations. This review will appraise the literature with regards to the development and management of palpitations in the cancer patient.

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How to Manage Atrial Fibrillation Secondary to Ibrutinib

Cited by 19 publications

References 8 publications

Real-World Persistence and Time to Next Treatment With Ibrutinib in Patients With Chronic Lymphocytic Leukemia/Small Lymphocytic Lymphoma Including Patients at High Risk for Atrial Fibrillation or Stroke

Real-World Persistence and Time to Next Treatment With Ibrutinib in Patients With Chronic Lymphocytic Leukemia/Small Lymphocytic Lymphoma Including Patients at High Risk for Atrial Fibrillation or Stroke

Use of BTK Inhibitors in Chronic Lymphocytic Leukemia/Small Lymphocytic Lymphoma (CLL/SLL): A Practical Guidance

Palpitations in the Cancer Patient

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