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Cardiotoxicity of BTK inhibitors: ibrutinib and beyond.
- Source :
-
Expert review of hematology [Expert Rev Hematol] 2022 Apr; Vol. 15 (4), pp. 321-331. Date of Electronic Publication: 2022 Apr 22. - Publication Year :
- 2022
-
Abstract
- Introduction: The development of Bruton<apos;>s Tyrosine Kinase (BTK) inhibitors has transformed the treatment of B-cell malignancies and other non-malignant conditions. Management of the unique cardiotoxic profile of these agents requires prompt recognition and a multi-disciplinary approach.<br />Areas Covered: The increasing indications and addition of newer agents to clinical practice and emergence of BTK inhibitor-related cardiac adverse events have complicated the management decisions for utilization of this class of therapy. We review the incidence, mechanisms, and management approaches for BTK inhibitor-related atrial fibrillation, hypertension, and ventricular arrhythmias.<br />Expert Opinion: The newer BTK inhibitor acalabrutinib represents a new standard of care in front-line chronic lymphocytic leukemia (CLL) given the results of the ELEVATE-RR trial demonstrating comparable efficacy and a more favorable toxicity profile especially with regard to cardiac adverse events as compared to ibrutinib. Often not recognized by clinicians, BTK inhibitor-induced hypertension is common and can be severe, requiring prompt recognition and initiation or adjustment of anti-hypertensive medications to prevent major adverse cardiac outcomes. Novel BTK inhibitors in development are being designed to overcome the patterns of resistance from first-generation agents and to minimize off-target kinase activity, with promising toxicity profiles in early trials.
- Subjects :
- Adenine analogs & derivatives
Agammaglobulinaemia Tyrosine Kinase
Cardiotoxicity drug therapy
Cardiotoxicity etiology
Humans
Piperidines
Protein Kinase Inhibitors adverse effects
Pyrimidines adverse effects
Hypertension
Leukemia, Lymphocytic, Chronic, B-Cell drug therapy
Leukemia, Lymphocytic, Chronic, B-Cell pathology
Subjects
Details
- Language :
- English
- ISSN :
- 1747-4094
- Volume :
- 15
- Issue :
- 4
- Database :
- MEDLINE
- Journal :
- Expert review of hematology
- Publication Type :
- Academic Journal
- Accession number :
- 35437106
- Full Text :
- https://doi.org/10.1080/17474086.2022.2067526