Department of Dermatology, Mayo Clinic, Rochester, Minnesota.
Alix School of Medicine, Mayo Clinic, Rochester, Minnesota.
Dermatol Surg. 2022 Nov 1;48(11):1166-1170. doi: 10.1097/DSS.0000000000003590. Epub 2022 Sep 8.
Ibrutinib, an irreversible Bruton tyrosine kinase inhibitor, has been associated with an increased risk of bleeding. There is a paucity of data on the risk of bleeding in patients on ibrutinib undergoing dermatologic surgery.
To determine the frequency of bleeding complications associated with ibrutinib in patients undergoing dermatologic surgery.
A retrospective, single-center, case-control study of patients on ibrutinib undergoing skin surgery between January 2013 and March 2020 compared with sex, disease, and age-matched control patients undergoing cutaneous surgeries.
A total of 75 surgeries performed on 37 case patients and 116 surgeries performed on 64 control patients were included. Ibrutinib was associated with a statistically significant increased rate of bleeding events (6/75 [8%] vs 1/116 [0.8%], p -value = .02). Compared with ibrutinib patients who did not have a bleeding event, those on ibrutinib who suffered bleeding were all men, older (mean age 82.7 vs 73.0, p -value= .01), and had lower mean platelet counts (104.0 vs 150.5 K/μL, p -value = .03).
Ibrutinib may be associated with increased risk of bleeding in patients with hematologic malignancies, particularly older men with lower platelet levels and on multiple anticoagulants. Transient discontinuation of ibrutinib should be considered for dermatologic surgeries.
伊布替尼是一种不可逆的布鲁顿酪氨酸激酶抑制剂，与出血风险增加相关。在接受皮肤科手术的伊布替尼患者中，关于出血风险的数据很少。
确定接受皮肤科手术的伊布替尼患者出血并发症的频率。
对 2013 年 1 月至 2020 年 3 月期间接受皮肤手术的伊布替尼患者进行回顾性、单中心、病例对照研究，与接受皮肤手术的性别、疾病和年龄匹配的对照患者进行比较。
共纳入 37 例病例患者的 75 例手术和 64 例对照患者的 116 例手术。伊布替尼与出血事件的发生率显著增加相关（6/75 [8%]比 1/116 [0.8%]，p 值=.02）。与未发生出血事件的伊布替尼患者相比，发生出血的伊布替尼患者均为男性、年龄较大（平均年龄 82.7 比 73.0，p 值=.01），且平均血小板计数较低（104.0 比 150.5 K/μL，p 值=.03）。
伊布替尼可能与血液恶性肿瘤患者出血风险增加相关，尤其是血小板水平较低且服用多种抗凝剂的老年男性。对于皮肤科手术，应考虑暂时停用伊布替尼。
