[Ibrutinib-associated atrial fibrillation : A therapeutic challenge]

Ann Cardiol Angeiol (Paris). 2022 Nov;71(5):321-324. doi: 10.1016/j.ancard.2022.07.005. Epub 2022 Sep 15.
[Article in French]

Abstract

Ibrutinib is a potent Bruton tyrosine kinase inhibitor and is an effective and well-tolerated treatment for a variety of lymphoid diseases. However, its use is associated with an increased incidence of atrial fibrillation ranging from 4% to 16%. New onset atrial fibrillation in cancer patients is associated with a significantly higher risk of heart failure and thromboembolism, even after adjusting for known risk factors. Ibrutinib also inhibits platelet activation and decisions regarding anticoagulation must be carefully weighed against this increased risk of bleeding. It is well-known that the anti-arrhythmic and antithrombotic strategy for atrial fibrillation related to ibrutinib has its own characteristics. Physicians should be familiar with the special management considerations imposed by this drug. Indeed, the co-prescription of therapy in combination with ibrutinib must be carefully weighed in view of its numerous drug interactions. We review the potential mechanisms and incidence of ibrutinib-associated atrial fibrillation.

Keywords: Atrial fibrillation; Cardio-oncology; Hematology; Ibrutinib; Interaction; cardio-oncologie; fibrillation atriale; hématologie; interaction.

Publication types

  • Review
  • English Abstract

MeSH terms

  • Anticoagulants / therapeutic use
  • Atrial Fibrillation* / chemically induced
  • Atrial Fibrillation* / drug therapy
  • Humans
  • Piperidines / adverse effects
  • Pyrazoles / adverse effects
  • Pyrimidines / adverse effects

Substances

  • ibrutinib
  • Pyrazoles
  • Pyrimidines
  • Piperidines
  • Anticoagulants