Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2023 Sep;25(9):941-958.
doi: 10.1007/s11886-023-01916-4. Epub 2023 Jul 27.

Diagnosis and Management of Cardiovascular Effects of Bruton's Tyrosine Kinase Inhibitors

Nazanin Aghel #  1   2 , Rocio C Baro Vila #  3   4 , Michelle Lui  5 , Christopher Hillis  6 , Darryl P Leong  7   3
Affiliations
Review

Diagnosis and Management of Cardiovascular Effects of Bruton's Tyrosine Kinase Inhibitors

Nazanin Aghel et al. Curr Cardiol Rep. 2023 Sep.

Abstract

Purpose of review: Bruton's tyrosine kinase inhibitors (BTKis) have changed the treatment and prognosis of several B-cell malignancies. However, since the approval of the first BTKi, ibrutinib, reports of cardiovascular adverse events especially atrial fibrillation have arisen. In this review, we discuss the cardiovascular side effects of BTKis and the management of these toxicities in clinical practice.

Recent findings: BTKIs increase the risks of atrial fibrillation, bleeding, hypertension, heart failure, and potentially ventricular arrhythmia. Newer second and third-generation BTKis appear to have a lower risk of cardiovascular adverse events; however, long-term follow-up data are not available for these new BTKis. BTKis are an effective treatment for some B-cell malignancies; however, they can cause cardiovascular side effects. The best preventive strategies to minimize cardiovascular complications remain undefined. Currently, a practical approach for managing patients receiving BTKis includes the management of cardiovascular risk factors and side effects of BTKis to prevent interruption of cancer treatment.

Keywords: Atrial fibrillation; B-cell malignancies; Bruton’s tyrosine kinase inhibitor; Cardio-Oncology; Heart failure; Ibrutinib.

PubMed Disclaimer

References

Papers of particular interest, published recently, have been highlighted as: •  Of importance •• Of major importance
    1. Aoki Y, Isselbacher KJ, Pillai S. Bruton tyrosine kinase is tyrosine phosphorylated and activated in pre-B lymphocytes and receptor-ligated B cells. Proc Natl Acad Sci USA. 1994;91(22):10606–9. https://doi.org/10.1073/PNAS.91.22.10606 . - DOI - PubMed - PMC
    1. Shadman M. Diagnosis and treatment of chronic lymphocytic leukemia: a review. JAMA. 2023;329(11):918–32. https://doi.org/10.1001/JAMA.2023.1946 . - DOI - PubMed
    1. Fischer K, et al. Venetoclax and obinutuzumab in patients with CLL and coexisting conditions. N Engl J Med. 2019;380(23):2225–36. https://doi.org/10.1056/NEJMOA1815281/SUPPL_FILE/NEJMOA1815281_DATA-SHAR... . - DOI - PubMed
    1. Wang ML, et al. Long-term follow-up of MCL patients treated with single-agent ibrutinib: updated safety and efficacy results. Blood. 2015;126(6):739–45. https://doi.org/10.1182/BLOOD-2015-03-635326 . - DOI - PubMed - PMC
    1. Brown JR, et al. Zanubrutinib or Ibrutinib in Relapsed or Refractory Chronic Lymphocytic Leukemia. N Engl J Med. 2023;388(4):319–32. https://doi.org/10.1056/NEJMOA2211582/SUPPL_FILE/NEJMOA2211582_DATA-SHAR... . - DOI - PubMed

MeSH terms

Substances

LinkOut - more resources