Hemostasis and Thrombosis Unit.
Hematology Unit, Department of Hematology and Oncology, AOPC, Catanzaro, Italy.
Blood Coagul Fibrinolysis. 2021 Mar 1;32(2):159-161. doi: 10.1097/MBC.0000000000000981.
Ibrutinib is the first clinically approved inhibitor of Bruton's tyrosine kinase, an essential enzyme for survival and proliferation of B cells by activating the B-cell receptor-signalling pathway. Ibrutinib has been shown to be highly effective in B-cell malignancies and is recommended in current international guidelines as a first-line and/or second-line treatment of chronic lymphocytic leukemia. The drug has a favorable tolerability and safety profile but the occurrence of specific side effects (e.g. atrial fibrillation, bleeding and hypertension). If atrial fibrillation is diagnosed, anticoagulant therapy may be required. Such patients receiving concomitant anticoagulation should be followed closely. DOAC is preferred over a VKA because of the lower risk of major bleeding events and because of the favorable stroke risk--benefit profile. Of all, Dabigatran offers the availability of an antidote and shows reduced potential for CYP3A4 interactions. We report the cases relating to three patients in concomitant therapy with Ibrutinib and Dabigatran.
伊布替尼是首个临床批准的布鲁顿酪氨酸激酶抑制剂，通过激活 B 细胞受体信号通路，是 B 细胞存活和增殖所必需的酶。伊布替尼已被证明在 B 细胞恶性肿瘤中非常有效，目前国际指南推荐将其作为慢性淋巴细胞白血病的一线和/或二线治疗药物。该药具有良好的耐受性和安全性，但会出现特定的副作用（如心房颤动、出血和高血压）。如果诊断出心房颤动，可能需要抗凝治疗。此类接受同时抗凝治疗的患者应密切随访。与 VKA 相比，DOAC 更具优势，因为前者发生大出血事件的风险较低，且具有良好的卒中风险获益比。其中，达比加群特有的解毒剂，且潜在的 CYP3A4 相互作用减少。我们报告了三例同时接受伊布替尼和达比加群治疗的患者的病例。
