RT Journal Article
SR Electronic
T1 Association between ibrutinib treatment and hypertension
JF Heart
JO Heart
FD BMJ Publishing Group Ltd and British Cardiovascular Society
SP 445
OP 450
DO 10.1136/heartjnl-2021-319110
VO 108
IS 6
A1 Dae Hyun Lee
A1 Fahad Hawk
A1 Kieun Seok
A1 Matthew Gliksman
A1 Josephine Emole
A1 Isaac B Rhea
A1 Federico Viganego
A1 Allan Welter-Frost
A1 Merna Armanious
A1 Bijal Shah
A1 Juliio C Chavez
A1 Javier Pinilla-Ibarz
A1 Matthew B Schabath
A1 Michael Fradley
YR 2022
UL http://heart.bmj.com/content/108/6/445.abstract
AB Background Ibrutinib is a tyrosine kinase inhibitor most commonly associated with atrial fibrillation. However, additional cardiotoxicities have been identified, including accelerated hypertension. The incidence and risk factors of new or worsening hypertension following ibrutinib treatment are not as well known.Methods We conducted a retrospective study of 144 patients diagnosed with B cell malignancies treated with ibrutinib (n=93) versus conventional chemoimmunotherapy (n=51) and evaluated their effects on blood pressure at 1, 2, 3 and 6 months after treatment initiation. Descriptive statistics were used to compare baseline characteristics for each treatment group. Fisher’s exact test was used to identify covariates significantly associated with the development of hypertension. Repeated measures analyses were conducted to analyse longitudinal blood pressure changes.Results Both treatments had similar prevalence of baseline hypertension at 63.4% and 66.7%, respectively. There were no differences between treatments by age, sex and baseline cardiac comorbidities. Both systolic and diastolic blood pressure significantly increased over time with ibrutinib compared with baseline, whereas conventional chemoimmunotherapy was not associated with significant changes in blood pressure. Baseline hypertensive status did not affect the degree of blood pressure change over time. A significant increase in systolic blood pressure (defined as more than 10 mm Hg) was noted for ibrutinib (36.6%) compared with conventional chemoimmunotherapy (7.9%) at 1 month after treatment initiation. Despite being hypertensive at follow-up, 61.2% of patients who were treated with ibrutinib did not receive adequate blood pressure management (increase or addition of blood pressure medications). Within the ibrutinib group, of patients who developed more than 20 mm Hg increase in systolic blood pressure, only 52.9% had hypertension management changes.Conclusions Ibrutinib is associated with the development of hypertension and worsening of blood pressure. Cardiologists and oncologists must be aware of this cardiotoxicity to allow timely management of blood pressure elevations.No data are available.