Hypertension treatment for patients receiving ibrutinib: a multicenter retrospective study

• DOI: 10.1182/bloodadvances.2023011569
• Publication Date: 2024-02-05T14:04:58Z
• Authors: Laura Samples; Jenna Voutsinas; Bita Fakhri; Sirin Khajavian; Stephen Spurgeon; Deborah Stephens; Alan Skarbnik; Anthony Mato; Catherine Broome; Ajay Gopal; Stephen Smith; Ryan Lynch; Magdalena Rainey; Myung Sun Kim; Odeth Barrett-Cam...; Emily Hemond; Mazie Tsang; Daniel Ermann; Nikita Malakhov; Danielle Rao; Mehrdad Shakib-Azar; Beth Morrigan; Ayushi Chauhan; Thomas Plate; Ted Gooley; Kellie Ryan; Frederick Lansigan; Brian Hill; Georgios Pongas; Sameer A. Parikh; Lindsey Roeker; John N. Allan; Richard Cheng; Chaitra Ujjani; Mazyar Shadman
• Keywords: Male; Lymphoid Neoplasia; Adenine; Middle Aged; 03 medical and health sciences; Pyrimidines; 0302 clinical medicine; Piperidines; Hypertension; Agammaglobulinaemia Tyrosine Kinase; Humans; Pyrazoles; Female; Protein Kinase Inhibitors; Antihypertensive Agents; Retrospective Studies; Aged

Abstract Although Bruton tyrosine kinase inhibitors (BTKis) are generally well tolerated and less toxic than chemotherapy alternatives used to treat lymphoid malignancies, BTKis like ibrutinib have the potential cause new or worsening hypertension (HTN). Little is known about optimal treatment of BTKi-associated HTN. Randomly selected patients with malignancies on a BTKi antihypertensive drug(s) at least 3 months follow-up data were sorted into 2 groups: those diagnosed HTN before initiation (prior-HTN), after (de novo HTN). Generalized estimating equations assessed associations between time varying mean arterial pressures (MAPs) individual anti-HTN drug categories. Of 196 included in study, 118 had prior-HTN, 78 developed de Statistically significant MAP reductions observed prior-HTN who took β blockers (BBs) hydrochlorothiazide (HCTZ), (−5.05 mmHg; 95% confidence interval [CI], 10.0 −0.0596; P = .047), either an angiotensin converting enzyme inhibitor (ACEi) receptor blocker (ARB) HCTZ (−5.47 CI, 10.9 −0.001; .05). These regimens also correlated greatest percentages normotensive MAPs. Treatment taking challenging may require multiple antihypertensives. Patients appear benefit from combination BBs HCTZ, whereas ACEi/ARBs HCTZ. results should be confirmed prospective studies.